NPIMap

Organization Active NPI

Providence Health & Services - Washington

Doing business as Providence ElderPlace

  • Exclusive Provider Organization
  • Seattle, WA
National Provider Identifier
1881681518
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Doing business as
Providence ElderPlace
Practice address
4515 Martin Luther King Jr Way S
Suite 100
Seattle, WA 98108-2182
Phone
(206) 320-5325
Fax
(206) 760-6339
NPI assigned
Sep 27, 2005
Last updated
Sep 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ellen Garcia, MPH
Title
Executive Director
Phone
(206) 320-5325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X NU Primary

Addresses

Primary practice location

4515 Martin Luther King Jr Way S
Suite 100
Seattle, WA 98108-2182

Mailing address

2001 Lind Ave SW
Suite 160
Renton, WA 98057-3303
Phone (206) 320-5325

Other names 1

  • Providence ElderPlace Doing business as

National Provider Directory

National Provider Directory

Locations

2001 Lind Ave SW
Ste 160
Renton, WA 98057

4515 Martin Luther King Jr Way S
Ste 100
Seattle, WA 98108
Phone (206) 320-5325

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1881681518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 LIND AVE SW",
            "address_2": "SUITE 160",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573303",
            "telephone_number": "206-320-5325",
            "fax_number": "206-760-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 MARTIN LUTHER KING JR WAY S",
            "address_2": "SUITE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981082182",
            "telephone_number": "206-320-5325",
            "fax_number": "206-760-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "206-320-5325",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence ElderPlace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.