Healthcare Provider Details

I. General information

NPI: 1972646958
Provider Name (Legal Business Name): UNIVERSITY OF WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-6151
US

IV. Provider business mailing address

155 NE 100TH ST SUITE 506
SEATTLE WA
98125-8012
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-3300
  • Fax:
Mailing address:
  • Phone: 206-598-6474
  • Fax: 206-598-4959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberH128
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberH128
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberH128
License Number StateWA

VIII. Authorized Official

Name: MR. WELDON E IHRIG
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 206-543-6410