Providence Health System of Washington
NPI #1750434098 in Chehalis, Washington
Provider Information
- NPI Number
- 1750434098
- Entity Type
- Organization
- Organization Name
- Providence Health System of Washington
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Jan 19, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 500 SE WASHINGTON AVE
- City
- Chehalis
- State
- Washington
- ZIP Code
- 98532-3058
- Phone
- (360) 740-6542
Authorized Official
- Name
- KEN BOUCHER
- Title
- ASSISTANT ADMINISTRATOR
- Phone
- (360) 330-8541
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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