| St Joseph Hospital Psychiatric Professional Services | |
|
1717 S J St Tacoma WA 98405-4933 | |
| (253) 426-6691 | |
| (253) 426-6492 |
| Full Name | St Joseph Hospital Psychiatric Professional Services |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1717 S J St, Tacoma, Washington |
| Authorized Official Name and Position | Mike Fitzgerald (VP, FINANCIAL OPS) |
| Authorized Official Contact | 2535524105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Joseph Hospital Psychiatric Professional Services 1717 S J St Tacoma WA 98405-4933 Ph: (253) 426-6691 | St Joseph Hospital Psychiatric Professional Services 1717 S J St Tacoma WA 98405-4933 Ph: (253) 426-6691 |
| NPI Number | 1497978100 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 03/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497978100 | NPI | - | NPPES |
| 8910986 | Other | WA | STATE CRIME VICTIMS |
| 078200 | Other | WA | STATE L&I |
| 7023369 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | MD00021407 (Washington) | Primary |
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