PROVIDENCE HEALTH & SERVICES WASHINGTON

SHELTON, WA
NPI1073744850
Doing Business AsPROVIDENCE ST PETER HOSPITAL
Entity TypeOrganization
Authorized ContactNICOLE QUINN
Payor Credentialing Manager
425-525-6715
Organization Subpart ?No
Primary Taxonomy261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder
Additional Taxonomies276400000X Rehabilitation, Substance Use Disorder Unit
Enumeration Date2009-07-28
Last Update Date2010-12-22
Business Address
PROVIDENCE HEALTH & SERVICES WASHINGTON
2505 OLYMPIC HWY N. STE 140
SHELTON, WA 98584-2978
Phone number: 360-432-8692
Mailing Address
PROVIDENCE HEALTH & SERVICES WASHINGTON
PO BOX 34439
SEATTLE, WA 98124-1439
Phone number: 425-525-6778