Provider Demographics
NPI:1669639712
Name:UNIVERSITY OF WASHINGTON
Entity Type:Organization
Organization Name:UNIVERSITY OF WASHINGTON
Other - Org Name:UNIVERSITY OF WASHINGTON MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE EXECUTIVE DIRECTOR CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:ISHIZUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-598-6305
Mailing Address - Street 1:PO BOX 24975
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0975
Mailing Address - Country:US
Mailing Address - Phone:206-598-0502
Mailing Address - Fax:206-598-0516
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-598-0502
Practice Address - Fax:206-598-0516
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF WASHINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-16
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-128282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0170851OtherL&I PIN
WA8940597OtherL&I CRIME VICTIM PIN
WA9636606Medicaid
WA9636606Medicaid