Provider Demographics
NPI:1699092718
Name:WASHINGTON VACCINE ASSOCIATION
Entity type:Organization
Organization Name:WASHINGTON VACCINE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-928-2242
Mailing Address - Street 1:PO BOX 94002
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-9402
Mailing Address - Country:US
Mailing Address - Phone:888-928-2224
Mailing Address - Fax:888-928-2222
Practice Address - Street 1:1700 7TH AVE STE 1810
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1397
Practice Address - Country:US
Practice Address - Phone:888-928-2224
Practice Address - Fax:888-928-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603004554251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare