DEPARTMENT OF SOCIAL DEPT OF SHS DIV OF INSTNS (NPI# 1467440602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467440602 |
| Entity Type | Organization |
| Organization Name | DEPARTMENT OF SOCIAL DEPT OF SHS DIV OF INSTNS |
| Other Organization Name | EASTERN STATE HOSPITAL |
| Practice Address |
850 Maple St Medical Lake WA 99022-0800 |
| Mailing Address |
Po Box 800 850 Maple St Medical Lake WA 99022-0800 |
| Practice Telephone | 5095654000 |
| Practice Fax Number | 5095654705 |
| Mailing Telephone | 5095654000 |
| Mailing Fax Number | 5095654705 |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2018-08-02 |
| Authorized Official Name | MARK A. KETTNER (CHIEF EXECUTIVE OFFICER/AUTHORIZED) |
| Authorized Official Telephone | 5095654351 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| Eastern State Hospital | Doing Business As Name - Organization |
| Street Address |
850 MAPLE ST |
| City | MEDICAL LAKE |
| State | WA |
| Zip Code | 99022-0800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417462227 | Alicia Burton Dds Pllc | Clinic/Center | 47 E. Wa 902, Medical Lake, WA 99022 | 2017-12-04 |
| 1487100038 | Tammy Lee Adler | Pharmacist | 1010 W Fir St, Medical Lake, WA 99022 | 2016-09-01 |
| 1902281959 | Carmen Joy Berg | Pharmacist | 2320 South Salnave Road, Medical Lake, WA 99022 | 2015-07-20 |
| 1033546288 | Torrance Whitney Baldwin | Speech-Language Pathologist | 116 West 3rd St., Medical Lake, WA 99022 | 2013-10-02 |
| 1144572710 | Keri Lea Wissink | Speech-Language Pathologist | 116 West Thrird Street, Medical Lake, WA 99022 | 2012-10-08 |
| 1609153766 | Dutton Veterinary Medicine Pllc | Special Hospital | 212 East Lake Street, Medical Lake, WA 99022 | 2011-11-03 |
| 1881912962 | Susan L Vanwormer | Counselor | 108 N. Jefferson, Medical Lake, WA 99022 | 2010-05-13 |
| 1467774232 | Ryan K Love | Dentist | N 123 Brower Street, Medical Lake, WA 99022 | 2010-02-22 |
| 1023263464 | Emily S Mildes | Nurse Practitioner | 1451 W Maple, Medical Lake, WA 99022 | 2008-11-26 |
| 1619005014 | Maria Lydia Montenegro | General Practice | 2320 Salnave Rd, Lakeland Village, Medical Lake, WA 99022 | 2007-02-28 |
| Find all providers in zip 99022 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679651970 | Eastern State Hospital Pharmacy | Psychiatric Hospital | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750881017 | Rainier Springs, LLC | Psychiatric Hospital | 2805 Ne 129th St, Vancouver, WA 98686-3324 | 2018-02-13 |
| 1679020150 | Vest Seattle, LLC | Psychiatric Hospital | 3955 156th St, Marysville, WA 98271 | 2016-09-01 |
| 1871726570 | Recovery Innovations, Inc | Psychiatric Hospital | 2150 Freeman Road East, Fifie, WA 98424-3776 | 2009-08-27 |
| 1083676340 | Va Puget Sound Health Care System | Psychiatric Hospital | Va Puget Sound Health Care System, American Lake D, 9600 Veterans Drive Sw, Tacoma, WA 98493-0001 | 2006-04-03 |
| 1487648721 | Child Study and Treatment Center | Psychiatric Hospital | 8805 Steilacoom Blvd Sw, Lakewood, WA 98498-4770 | 2005-09-01 |
| 1649804253 | Vest Thurston LLC | Psychiatric Hospital | 605 Woodland Square Loop Se, Lacey, WA 98503-1045 | 2020-02-24 |
| 1336605849 | Vest Thurston LLC | Psychiatric Hospital | 605 Woodland Square Loop Se, Lacey, WA 98503-1045 | 2019-02-20 |
| 1932698107 | Spokane Behavioral Health LLC | Psychiatric Hospital | 104 W 5th Ave, Spokane, WA 99204-4880 | 2018-05-03 |
| 1508365297 | Rebecca Noll Walkling | Psychiatric Hospital | 10710 Mukilteo Speedway, Mukilteo, WA 98275-5021 | 2018-02-08 |
| 1336558097 | Our Lady of Lourdes Hospital At Pasco | Psychiatric Hospital | 1175 Carondelet Dr, Richland, WA 99354-3300 | 2014-08-07 |
| Find all providers with the same taxonomy | ||||
| City | MEDICAL LAKE |
| Zip Code | 99022 |
Please comment or provide details below to improve the information on DEPARTMENT OF SOCIAL DEPT OF SHS DIV OF INSTNS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.