Provider Demographics
NPI:1558333682
Name:HIGHLINE MEDICAL CENTER
Entity Type:Organization
Organization Name:HIGHLINE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-431-5237
Mailing Address - Street 1:16251 SYLVESTER RD SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3017
Mailing Address - Country:US
Mailing Address - Phone:206-431-5310
Mailing Address - Fax:206-246-4367
Practice Address - Street 1:16251 SYLVESTER RD SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3017
Practice Address - Country:US
Practice Address - Phone:206-431-5310
Practice Address - Fax:206-246-4367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-126276400000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7000565Medicaid
WA7940406Medicaid
WA3319506Medicaid
WAG000144700Medicare PIN
WAC46508Medicare PIN
WA3319506Medicaid
WAG0001411000Medicare PIN
WA500011Medicare ID - Type UnspecifiedMEDICARE
WAG000185100Medicare PIN
WAG000161200Medicare PIN