OrganizationActive
Department of Social Dept of Shs Div of Instns
NPI 1467440602 · Psychiatric Hospital · Medical Lake, WA
Provider details
- NPI number
- 1467440602
- Entity type
- Organization
- Primary specialty
- Psychiatric HospitalHospitals
- Organization subpart
- No
- Authorized official
- Jessica Graham, Director, Revenue Cycle(509) 565-4131
Specialties & taxonomies
Hospitals
Practice location
850 Maple St
Medical Lake, WA 99022-0800
Phone: (509) 565-4000
Fax: (509) 565-4705
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 800
Medical Lake, WA 99022-0800
Other names (DBA / former)
- Doing business as
- Eastern State Hospital
- Doing business as
- Eastern State Hospital
Registry dates
- Enumerated
- 2005-10-12
- Last updated
- 2022-03-10
- Certified
- 2022-02-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.