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General NPI Number Information
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NPI Number | 1780926824
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Entity Type | Organization
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Legal Business Name | SEATTLE CHILDRENS HOSPITAL
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 4800 SAND POINT WAY NE M/S O.A.9.120.1
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City | SEATTLE
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State | WA
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Zip | 98105-3901
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Country | US
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Telephone | 509-436-0318
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 SAND POINT WAY NE M/S O.A.9.120.1
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City | SEATTLE
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State | WA
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Zip | 98105-3901
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Country | US
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Telephone | 509-436-0318
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Fax |
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Authorized Official
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Title or Position | SPORTS MEDICINE DIRECTOR
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Name | MONIQUE BURTON
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Credential | MD
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Telephone | 509-436-0318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | A160183970
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License Number State | WA
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