Organization
NAVOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GLENN ROBERTSON (CEO)
(253) 403-1272
Entity
Organization
Contact information
Practice address
2600 SW HOLDEN ST, SEATTLE, WA 98126-3505
(206) 933-7000
Mailing address
P.O. BOX 5299, MS: 820-5-PCO, TACOMA, WA 98415-0299
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
0007470
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2128352
—
WA
01
—
504009
MEDICARE PROVIDER NUMBER
WA
Enumeration date
02/07/2007
Last updated
08/04/2025
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