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General NPI Number Information
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NPI Number | 1114472560
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Entity Type | Organization
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Legal Business Name | UW MEDICINE CENTER FOR PRECISION DIAGNOSTICS
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 1959 NE PACIFIC ST HSB H-564, BOX 357655
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City | SEATTLE
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State | WA
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Zip | 98195-7655
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Country | US
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Telephone | 206-543-0459
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Fax |
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Provider Business Mailing Address
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Address Line | 1959 NE PACIFIC ST HSB H-564, BOX 357655
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City | SEATTLE
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State | WA
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Zip | 98195-7655
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Country | US
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Telephone | 206-543-0459
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATION
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Name | ANDREW FLANNERY
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Credential |
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Telephone | 206-685-1176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 50D2093534
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License Number State | WA
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