Healthcare Provider Details
I. General information
NPI: 1811091234
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
- Phone: 206-520-5000
- Fax:
- Phone: 206-598-1950
- Fax: 206-598-0961
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | H-029 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | H-029 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | H-029 |
| License Number State | WA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336I0012X |
| Taxonomy | Institutional Pharmacy |
| License Number | H-029 |
| License Number State | WA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | H-029 |
| License Number State | WA |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | H-029 |
| License Number State | WA |
VIII. Authorized Official
Name: MS.
SOMMER
KLEWENO
WALLEY
Title or Position: INTERIM CEO
Credential:
Phone: 206-744-3000