Healthcare Provider Details

I. General information

NPI: 1548635683
Provider Name (Legal Business Name): UNIVERSITY OF WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2015
Last Update Date: 12/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 206-598-9949
  • Fax:
Mailing address:
  • Phone: 206-598-9949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PHILIP DOHERTY
Title or Position: PHARMACY REVENUE CYCLE MANAGER
Credential:
Phone: 206-598-6059