Provider Demographics
NPI:1457844219
Name:UW MEDICINE NORTHWEST PHYSICIANS
Entity Type:Organization
Organization Name:UW MEDICINE NORTHWEST PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-668-2774
Mailing Address - Street 1:11011 MERIDIAN AVE N STE 201
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8967
Mailing Address - Country:US
Mailing Address - Phone:206-668-4044
Mailing Address - Fax:206-668-4045
Practice Address - Street 1:11011 MERIDIAN AVE N STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8967
Practice Address - Country:US
Practice Address - Phone:206-668-4044
Practice Address - Fax:206-668-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2028349Medicaid