Provider Demographics
NPI:1164082384
Name:WASHINGTON INSTITUTE FOR COAGULATION
Entity Type:Organization
Organization Name:WASHINGTON INSTITUTE FOR COAGULATION
Other - Org Name:WASHINGTON CENTER FOR BLEEEDING DISORDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUSE-JARRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-614-1200
Mailing Address - Street 1:701 PIKE ST STE 1900
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3932
Mailing Address - Country:US
Mailing Address - Phone:206-614-1200
Mailing Address - Fax:206-614-1170
Practice Address - Street 1:701 PIKE ST STE 1900
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3932
Practice Address - Country:US
Practice Address - Phone:206-614-1200
Practice Address - Fax:206-614-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty