Provider Demographics
NPI:1972646958
Name:UNIVERSITY OF WASHINGTON
Entity type:Organization
Organization Name:UNIVERSITY OF WASHINGTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WELDON
Authorized Official - Middle Name:E
Authorized Official - Last Name:IHRIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-543-6410
Mailing Address - Street 1:155 NE 100TH ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-8012
Mailing Address - Country:US
Mailing Address - Phone:206-598-6474
Mailing Address - Fax:206-598-4959
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6151
Practice Address - Country:US
Practice Address - Phone:206-598-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH128332B00000X, 3336I0012X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA500008Medicare ID - Type UnspecifiedMEDICARE BILLING NUMBER
WA50S008Medicare ID - Type UnspecifiedMEDICARE BILLING NUMBER
WA50T008Medicare ID - Type UnspecifiedMEDICARE BILLING NUMBER