Provider Demographics
NPI:1518410935
Name:SWEDISH MEDICAL CENTER
Entity Type:Organization
Organization Name:SWEDISH MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THORACIC AND ESOPHAGEAL FELLOW
Authorized Official - Prefix:
Authorized Official - First Name:MATIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIHURA IRRIBARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-790-9461
Mailing Address - Street 1:1101 MADISON ST STE 900
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1347
Mailing Address - Country:US
Mailing Address - Phone:206-386-2392
Mailing Address - Fax:
Practice Address - Street 1:1101 MADISON ST STE 900
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1347
Practice Address - Country:US
Practice Address - Phone:206-386-2392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60646032208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty