Healthcare Provider Details

I. General information

NPI: 1720772387
Provider Name (Legal Business Name): UMBRELLA PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23511 56TH AVE W STE 105
MOUNTLAKE TERRACE WA
98043-5285
US

IV. Provider business mailing address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-546-2421
  • Fax: 206-542-9028
Mailing address:
  • Phone: 206-987-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE VANDERWERFF
Title or Position: VP REV CYCLE & HEALTH INFO INTEG
Credential:
Phone: 206-987-2000