Provider Demographics
NPI:1285674754
Name:WASHINGTON UNIVERSITY
Entity Type:Organization
Organization Name:WASHINGTON UNIVERSITY
Other - Org Name:WASHINGTON UNIVERSITY, DEPT OF ANESTHESIA PSYCHOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, CREDENTIALING OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:EGHIGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-273-0770
Mailing Address - Street 1:7425 FORSYTH BLVD
Mailing Address - Street 2:CAMPUS BOX 8221
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-2171
Mailing Address - Country:US
Mailing Address - Phone:314-935-0770
Mailing Address - Fax:314-935-0575
Practice Address - Street 1:660 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1010
Practice Address - Country:US
Practice Address - Phone:314-286-1045
Practice Address - Fax:314-286-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO15-01999OtherUHC GROUP NUMBER
MO673341OtherAETNA HMO GROUP NUMBER
MO552990905Medicaid
IL92215225OtherIL BLUE SHIELD
MO610916400OtherDEPT OF LABOR NUMBER
MOCC6123Medicare PIN