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Providence Health & Services Washington
Home Health Agency in Lacey, Washington
NPI 1063415198

Providence Health & Services Washington is a Home Health Agency based in Seattle, WA. Providence Health & Services Washington practices in Lacey, WA. The NPI Number for Providence Health & Services Washington is 1063415198 and holds a License No. IS-420 (Washington).

The current practice location address for Providence Health & Services Washington is 4200 6Th Ave Se, Lacey, WA and can be reached out via phone at 360-459-8311 and via fax at 360-493-4657. You can also correspond with Providence Health & Services Washington through the mailing address at PO BOX 24666, SEATTLE, WA - 98124-0666 (mailing address contact number: 503-893-7120).

Location: 4200 6Th Ave Se, Lacey, WA, 98124-0666
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1063415198
Provider Name
Providence Health & Services Washington
Credential
Provider Entity Type
Organization
Address
4200 6Th Ave Se, Lacey, WA, 98124-0666
Phone Number
360-459-8311
Fax Number
360-493-4657
Provider Enumeration Date
05/23/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9040460 05 WA
9040452 05 WA
9040478 05 WA
9048661 05 WA
9040486 05 WA
institution
Provider Business Practice Location Address Details
Address
4200 6Th Ave Se
City
Lacey
State
Washington
Zip
98503-1042
Phone Number
360-459-8311
Fax Number
360-493-4657
person
Provider Business Mailing Address Details
Address
4200 6Th Ave Se
City
Lacey
State
Washington
Zip
98503-1042
Phone Number
360-459-8311
Fax Number
360-493-4657
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
251E00000X
License No.
IS-420 (Washington)
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
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