Healthcare Provider Details

I. General information

NPI: 1922102342
Provider Name (Legal Business Name): HARBORVIEW MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2499
US

IV. Provider business mailing address

PO BOX 34001
SEATTLE WA
98124-1001
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax:
Mailing address:
  • Phone: 206-598-1950
  • Fax: 206-598-0961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License NumberH-029
License Number StateWA

VIII. Authorized Official

Name: MS. SOMMER KLEWENO WALLEY
Title or Position: INTERIM CEO
Credential:
Phone: 206-744-3000