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General NPI Number Information
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NPI Number | 1043214596
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Entity Type | Organization
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Legal Business Name | VIRGINIA MASON MEDICAL CENTER
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 NE GILMAN BLVD
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City | ISSAQUAH
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State | WA
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Zip | 98027-2925
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Country | US
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Telephone | 425-557-8003
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Fax | 425-557-8021
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Provider Business Mailing Address
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Address Line | 100 NE GILMAN BLVD
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City | ISSAQUAH
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State | WA
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Zip | 98027-2925
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Country | US
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Telephone | 425-557-8003
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Fax | 425-557-8021
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Authorized Official
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Title or Position | LEAD PHARMACIST
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Name | MS. ROSE WONG
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Credential | RPH. PHARM D
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Telephone | 425-557-8003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 262010304679
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License Number State | WA
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