Provider Demographics
NPI:1720772387
Name:UMBRELLA PEDIATRICS PC
Entity Type:Organization
Organization Name:UMBRELLA PEDIATRICS PC
Other - Org Name:SEATTLE CHILDREN'S PRIMARY CARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP REV CYCLE & HEALTH INFO INTEG
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERWERFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-987-2000
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-2000
Mailing Address - Fax:
Practice Address - Street 1:23511 56TH AVE W STE 105
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-5285
Practice Address - Country:US
Practice Address - Phone:206-546-2421
Practice Address - Fax:206-542-9028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty