Provider Demographics
NPI:1720419716
Name:UNIVERSITY OF WASHINGTON
Entity Type:Organization
Organization Name:UNIVERSITY OF WASHINGTON
Other - Org Name:UW BEHAVIORAL RESEARCH AND THERAPY CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LINEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-543-9886
Mailing Address - Street 1:3935 UNIVERSITY WAY NE
Mailing Address - Street 2:BOX 355915
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-5915
Mailing Address - Country:US
Mailing Address - Phone:206-543-2782
Mailing Address - Fax:
Practice Address - Street 1:3935 UNIVERSITY WAY NE
Practice Address - Street 2:BOX 355915
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-5915
Practice Address - Country:US
Practice Address - Phone:206-543-2782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-128261QM0801X, 261QM0850X, 261QM0855X, 261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch