Healthcare Provider Details

I. General information

NPI: 1316001951
Provider Name (Legal Business Name): JANIINE GRACE BABCOCK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 06/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE SEATTLE CHILDREN'S, M1-13 HOSPITAL MEDICINE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE SEATTLE CHILDREN'S, M1-13 HOSPITAL MEDICINE
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-7370
  • Fax: 206-985-3201
Mailing address:
  • Phone: 206-987-7370
  • Fax: 206-985-3201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberMD20798
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberMD60342003
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberD0073591
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: