Healthcare Provider Details

I. General information

NPI: 1801132428
Provider Name (Legal Business Name): SEATTLE CHILDREN'S WENATCHEE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2012
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 N CHELAN AVE STE B
WENATCHEE WA
98801-6696
US

IV. Provider business mailing address

PO BOX 5371 RC-504
SEATTLE WA
98145-5005
US

V. Phone/Fax

Practice location:
  • Phone: 509-662-9266
  • Fax:
Mailing address:
  • Phone: 206-987-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE BEITEL
Title or Position: SVP AND CFO
Credential:
Phone: 206-987-4153