Healthcare Provider Details

I. General information

NPI: 1699092718
Provider Name (Legal Business Name): WASHINGTON VACCINE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 06/13/2020
Certification Date: 06/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 7TH AVE STE 1810
SEATTLE WA
98101-1397
US

IV. Provider business mailing address

PO BOX 94002
SEATTLE WA
98124-9402
US

V. Phone/Fax

Practice location:
  • Phone: 888-928-2224
  • Fax: 888-928-2242
Mailing address:
  • Phone: 888-928-2224
  • Fax: 888-928-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number603004554
License Number StateWA

VIII. Authorized Official

Name: PATRICK MILLER
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 888-928-2242