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Providence Health & Services Washington
Substance Use Disorder Rehabilitation Hospital Unit in Lacey, Washington
NPI 1689805509

Providence Health & Services Washington is a Substance Use Disorder Rehabilitation Hospital Unit based in Portland, WA. Providence Health & Services Washington practices in Lacey, WA. The NPI Number for Providence Health & Services Washington is 1689805509 and holds a License No. (Washington).

The current practice location address for Providence Health & Services Washington is 4800 College St Se, Lacey, WA and can be reached out via phone at 360-456-7575 and via fax at 360-493-5088. You can also correspond with Providence Health & Services Washington through the mailing address at PO BOX 3505, PORTLAND, OR - 97208-3505 (mailing address contact number: 425-525-6778).

Location: 4800 College St Se, Lacey, WA, 97208-3505
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1689805509
Provider Name
Providence Health & Services Washington
Credential
Provider Entity Type
Organization
Address
4800 College St Se, Lacey, WA, 97208-3505
Phone Number
360-456-7575
Fax Number
360-493-5088
Provider Enumeration Date
07/28/2009
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
50-0143 01 MEDICARE ID UNSPECIFIED
3400017 05 WA
institution
Provider Business Practice Location Address Details
Address
4800 College St Se
City
Lacey
State
Washington
Zip
98503-4389
Phone Number
360-456-7575
Fax Number
360-493-5088
person
Provider Business Mailing Address Details
Address
4800 College St Se
City
Lacey
State
Washington
Zip
98503-4389
Phone Number
360-456-7575
Fax Number
360-493-5088
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
261QR0405X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Hospital Units
Classification
Rehabilitation, Substance Use Disorder Unit
Speciality
-
Taxonomy
276400000X
License No.
()
Definition
A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.)
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