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General NPI Number Information
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NPI Number | 1538515382
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Entity Type | Organization
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Legal Business Name | HARBORVIEW MEDICAL CENTER
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 325 9TH AVE 325 9TH AVE
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City | SEATTLE
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State | WA
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Zip | 98104-2420
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Country | US
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Telephone | 206-744-5108
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Fax |
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Provider Business Mailing Address
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Address Line | 6344 34TH AVE SW
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City | SEATTLE
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State | WA
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Zip | 98126-3148
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Country | US
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Telephone | 253-327-4224
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MR. MICHAEL L NICHOLSON
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Credential | MSW
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Telephone | 253-327-4224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | CG60150416
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License Number State | WA
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