Provider Demographics
NPI:1730344276
Name:UNIVERSITY OF WASHINGTON MEDICAL CENTER
Entity type:Organization
Organization Name:UNIVERSITY OF WASHINGTON MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:KEISHO
Authorized Official - Last Name:SU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-260-0047
Mailing Address - Street 1:900 LENORA ST
Mailing Address - Street 2:#501
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 LENORA ST
Practice Address - Street 2:#501
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2720
Practice Address - Country:US
Practice Address - Phone:559-260-0047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML60020786282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital