Healthcare Provider Details

I. General information

NPI: 1851680664
Provider Name (Legal Business Name): ASSOCIATION OF CHMC AND UNIVERSITY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2011
Last Update Date: 04/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

969 STEVENS DR SUITE 1B
RICHLAND WA
99352-3525
US

IV. Provider business mailing address

PO BOX 50010
SEATTLE WA
98145-5003
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-0976
  • Fax: 509-946-0983
Mailing address:
  • Phone: 206-987-8450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number104242
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number104242
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number104242
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number104242
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number104242
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number104242
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number104242
License Number StateWA
# 8
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number104242
License Number StateWA

VIII. Authorized Official

Name: PATTI ADAMICH
Title or Position: ASSOC DIRECTOR OF FINANCE
Credential:
Phone: 206-987-8471