Provider Demographics
NPI:1871863605
Name:VIRGINIA MASON MEDICAL CENTER
Entity Type:Organization
Organization Name:VIRGINIA MASON MEDICAL CENTER
Other - Org Name:SANDPOINT PEDIATRICS
Other - Org Type:Other Name
Authorized Official - Title/Position:MKT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:NESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-223-6711
Mailing Address - Street 1:PO BOX 741515
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-1515
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:206-341-0274
Practice Address - Street 1:4575 SAND POINT WAY NE
Practice Address - Street 2:SUITE 108
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3950
Practice Address - Country:US
Practice Address - Phone:206-525-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60254262261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health