Provider Demographics
NPI:1699702050
Name:VIRGINIA MASON MEDICAL CENTER
Entity type:Organization
Organization Name:VIRGINIA MASON MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-341-1208
Mailing Address - Street 1:PO BOX 741515
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-1515
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:206-341-0274
Practice Address - Street 1:11695 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5268
Practice Address - Country:US
Practice Address - Phone:425-637-1855
Practice Address - Fax:206-344-7970
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRGINIA MASON MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-28
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH010261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9014090OtherMEDICARE
WA7139595Medicaid