Provider Demographics
NPI:1700861580
Name:UW MEDICINE NORTHWEST
Entity Type:Organization
Organization Name:UW MEDICINE NORTHWEST
Other - Org Name:NORTHWEST HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-368-1700
Mailing Address - Street 1:1550 NORTH 115TH STREET
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9733
Mailing Address - Country:US
Mailing Address - Phone:206-364-0500
Mailing Address - Fax:206-368-3029
Practice Address - Street 1:1550 NORTH 115TH STREET
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9733
Practice Address - Country:US
Practice Address - Phone:206-364-0500
Practice Address - Fax:206-368-3029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-130282N00000X
WAH-130HAC.FS00000130282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3340403Medicaid
WA500001Medicare Oscar/Certification
WA3340403Medicaid