| Providence St Peter Hospital | |
|
413 Lilly Rd Ne Olympia WA 98506-5133 | |
| (360) 491-9480 | |
| Not Available |
| Full Name | Providence St Peter Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 413 Lilly Rd Ne, Olympia, Washington |
| Authorized Official Name and Position | Donald Wayne Anderson (DIRECTOR REIMBURSEMENT ADMINISTRATI) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence St Peter Hospital Po Box 3505 Portland OR 97208-3505 Ph: (425) 525-6717 | Providence St Peter Hospital 413 Lilly Rd Ne Olympia WA 98506-5133 Ph: (360) 491-9480 |
| NPI Number | 1457550840 |
|---|---|
| Provider Enumeration Date | 07/16/2007 |
| Last Update Date | 10/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457550840 | NPI | - | NPPES |
| 129210 | Other | WA | L&I |
| 7025166 | Medicaid | WA | |
| 3500063 | Other | WA | MEDICAID INPATIENT |
| 8901337 | Other | WA | L&I CRIME VICTIMS |
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