Provider Demographics
NPI:1669416004
Name:HARBORVIEW MEDICAL CENTER
Entity type:Organization
Organization Name:HARBORVIEW MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIJALKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-744-3377
Mailing Address - Street 1:PO BOX 359885
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-9885
Mailing Address - Country:US
Mailing Address - Phone:206-598-6055
Mailing Address - Fax:206-598-6075
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-223-3218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARBORVIEW MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-16
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
WAHF000009853336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2107950OtherPK
WA6015291Medicaid