Healthcare Provider Details

I. General information

NPI: 1558333682
Provider Name (Legal Business Name): HIGHLINE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16251 SYLVESTER RD SW
BURIEN WA
98166-3017
US

IV. Provider business mailing address

16251 SYLVESTER RD SW
BURIEN WA
98166-3017
US

V. Phone/Fax

Practice location:
  • Phone: 206-431-5310
  • Fax: 206-246-4367
Mailing address:
  • Phone: 206-431-5310
  • Fax: 206-246-4367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License NumberH-126
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH-126
License Number StateWA

VIII. Authorized Official

Name: MR. RUSSELL WOOLLEY
Title or Position: COO
Credential:
Phone: 206-431-5237