Provider Demographics
NPI:1851495329
Name:HOSPICE OF SEATTLE
Entity Type:Organization
Organization Name:HOSPICE OF SEATTLE
Other - Org Name:PROVIDENCE HOSPICE OF SEATTLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLRIGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-254-5432
Mailing Address - Street 1:425 PONTIUS AVE N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5474
Mailing Address - Country:US
Mailing Address - Phone:206-320-4000
Mailing Address - Fax:206-320-7333
Practice Address - Street 1:425 PONTIUS AVE N
Practice Address - Street 2:SUITE 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5474
Practice Address - Country:US
Practice Address - Phone:206-320-4000
Practice Address - Fax:206-320-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3990173Medicaid
WA501515Medicare ID - Type UnspecifiedMEDICARE NUMBER