Healthcare Provider Details

I. General information

NPI: 1457904625
Provider Name (Legal Business Name): UNIVERSITY OF WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 REPUBLICAN ST BLDG F
SEATTLE WA
98109-4766
US

IV. Provider business mailing address

1959 NE PACIFIC ST # 356015
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-8380
  • Fax: 206-598-8334
Mailing address:
  • Phone: 206-598-6059
  • Fax: 206-598-6075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: STEVE FIJALKA
Title or Position: CHIEF PHARMACY OFFICER
Credential:
Phone: 206-744-3377