Provider Demographics
NPI:1467704841
Name:SEATTLE CHILDREN'S HOSPITAL
Entity Type:Organization
Organization Name:SEATTLE CHILDREN'S HOSPITAL
Other - Org Name:SEATTLE CHILDREN'S TRI-CITIES CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:S.V.P. AND C.F.O.
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEITEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-987-4153
Mailing Address - Street 1:PO BOX 5371
Mailing Address - Street 2:RC-504
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5005
Mailing Address - Country:US
Mailing Address - Phone:206-987-5770
Mailing Address - Fax:
Practice Address - Street 1:900 STEVENS DR
Practice Address - Street 2:SUITE 204
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3535
Practice Address - Country:US
Practice Address - Phone:509-946-0976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3306206Medicaid
503300Medicare Oscar/Certification