1164493847 NPI number — FRED HUTCHINSON CANCER CENTER

Table of content: (NPI 1164493847)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164493847 NPI number — FRED HUTCHINSON CANCER CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRED HUTCHINSON CANCER CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164493847
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
825 EASTLAKE AVE E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98109-4405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-606-6206
Provider Business Mailing Address Fax Number:
206-606-6299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 EASTLAKE AVE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98109-4405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-606-7222
Provider Business Practice Location Address Fax Number:
206-606-1025
Provider Enumeration Date:
01/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIDSON
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VP
Authorized Official Telephone Number:
206-667-6363

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  601883375 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 12033782 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: HS4751P , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: HP196 . This is a "PREMERA HEALTH PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3022936 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 505745003 . This is a "GROUP HEALTH NON BMT" identifier . This identifiers is of the category "OTHER".
  • Identifier: MC196 . This is a "PREMERA HEALTHY OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5858SE . This is a "REGENCE BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 806022900 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 412284 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 505745001 . This is a "GROUP HEALTH POST BMT OUT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1141698 . This is a "MERCY HORIZON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 149053 . This is a "LABOR & INDUSTRIES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 196 . This is a "PREMERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 505745002 . This is a "GROUP HEALTH BMT INPATIEN" identifier . This identifiers is of the category "OTHER".




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