VIRGINIA MASON MEDICAL CENTER (NPI# 1104974302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104974302 |
| Entity Type | Organization |
| Organization Name | VIRGINIA MASON MEDICAL CENTER |
| Other Organization Name | VIRGINIA MASON MEDICAL CENTER-PEDIATRICS |
| Practice Address |
2671 Ne 46th St Seattle WA 98105-5041 |
| Mailing Address |
1100 9th Ave Ms:m4-pfs Seattle WA 98101-2756 |
| Practice Telephone | 2065258000 |
| Practice Fax Number | 2065258070 |
| Mailing Telephone | 2065155811 |
| Mailing Fax Number | 2063410274 |
| Enumeration Date | 2007-01-07 |
| Last Update Date | 2016-05-23 |
| Authorized Official Name | STEVEN M SCHAEFER (VICE PRESIDENT) |
| Authorized Official Telephone | 2065155953 |
| Is Organization Subpart | Y |
| Parent Organization Name | VIRGINIA MASON MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7068174 | 05 |
| Other Name | Type Code |
|---|---|
| VIRGINIA MASON MEDICAL CENTER-PEDIATRICS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689130528 | Virginia Mason Medical Center | Clinic/Center | 909 University St Fl 2, Seattle, WA 98101-2772 | 2019-02-15 |
| 1306365184 | Virginia Mason Medical Center | Pharmacy | 5959 Corson Ave S Ste C-1, Seattle, WA 98108-2605 | 2017-09-13 |
| 1972884732 | Virginia Mason Medical Center | Clinic/Center | 1201 Terry Ave., Virginia Mason Medical Center X2-sm, Seattle, WA 98101 | 2011-09-07 |
| 1720073604 | Virginia Mason Medical Center | Skilled Nursing Facility | 2720 E Madison St, Seattle, WA 98112-4739 | 2005-09-15 |
| 1700880291 | Virginia Mason Medical Center | Pharmacy | 1201 Terry Ave, Seattle, WA 98101-2735 | 2005-06-13 |
| 1174527683 | Virginia Mason Medical Center | Pharmacy | 1100 Ninth Ave Ms: C1-po, Seattle, WA 98101 | 2005-06-13 |
| 1043214596 | Virginia Mason Medical Center | Pharmacy | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2005-06-10 |
| 1174164297 | Virginia Mason Medical Center | Clinic/Center | 925 Seneca St, Ms: H4-carrb, Seattle, WA 98101-2756 | 2019-09-30 |
| 1134511686 | Virginia Mason Medical Center | Durable Medical Equipment & Medical Supplies | 1100 9th Ave, Ms-h10slp, Seattle, WA 98101-2756 | 2015-02-20 |
| 1578902094 | Virginia Mason Medical Center | Durable Medical Equipment & Medical Supplies | 2671 Ne 46th St, Seattle, WA 98105 | 2013-06-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | VIRGINIA MASON MEDICAL CENTER | 1100 9th Ave, C/O Lynne Chafetz Ms Gb-Adm, Seattle, WA 98101-2756 |
| System for Award Management (SAM) Entities | VIRGINIA MASON MEDICAL CENTER | 1100 9th Ave, Seattle, WA 98101-2756 |
| Street Address |
2671 NE 46TH ST |
| City | SEATTLE |
| State | WA |
| Zip Code | 98105-5041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841291317 | Michael S Dudas | Pediatrics | 2671 Ne 46th St, Seattle, WA 98105-5041 | 2005-08-09 |
| 1437632072 | Kate Kapner | Nurse Practitioner | 2671 Ne 46th St, Seattle, WA 98105-5041 | 2018-09-10 |
| 1487186177 | Victoria Black Horse | Internal Medicine | 2671 Ne 46th St, Seattle, WA 98105-5041 | 2017-03-31 |
| 1689120271 | Alyssa Erickson-wayman | Nurse Practitioner | 2671 Ne 46th St, Seattle, WA 98105 | 2016-09-01 |
| 1811308893 | Marnonette J Marallag | Family Medicine | 2671 Ne 46th St, Seattle, WA 98105-5041 | 2014-05-13 |
| 1023436060 | Elizabeth Cochrane | Pediatrics | 2671 Ne 46th St, Seattle, WA 98105-5041 | 2014-04-05 |
| 1578902094 | Virginia Mason Medical Center | Durable Medical Equipment & Medical Supplies | 2671 Ne 46th St, Seattle, WA 98105 | 2013-06-18 |
| 1457797961 | Amanda Sarah Freed | Internal Medicine | 2671 Ne 46th St, Seattle, WA 98105-5041 | 2013-05-13 |
| 1447507462 | Angela M Black | Nurse Practitioner | 2671 Ne 46th St, Seattle, WA 98105 | 2012-08-09 |
| 1447519681 | Heather Christine Gupta | Pediatrics | 2671 Ne 46th St, Seattle, WA 98105-5041 | 2012-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326662396 | Dale Justin Podolsky | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 | 2020-06-04 |
| 1376170878 | Andrew Crompton Yazman | Pediatrics | 4800 Sand Point Way, Ne Oc.7.830, Seattle, WA 98105 | 2020-03-25 |
| 1427688845 | Daniela Michell Zepeda | Behavioral Analyst | 4616 25th Ave Ne Pmb 437, Seattle, WA 98105 | 2020-01-24 |
| 1255981189 | Emily King | Student in an Organized Health Care Education/Training Program | Mark Hawkins, Pa-c, Mpas, 4311 11th Ave Ne Suite 200, WA 98105 | 2019-09-12 |
| 1821659327 | Sara Katherine Horne | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Mb.11.500, Department of Anesthesiology and Pain Medicine, Seattle, Seattle, WA 98105 | 2019-06-25 |
| 1881252575 | Darryl Lee Wright | Peer Specialist | Gossett Place, 4719 12th Ave Ne, Seattle, WA 98105 | 2019-05-29 |
| 1487117891 | Nirupama Madhavan | Behavioral Analyst | 5001 25th Ave Ne, Seattle, WA 98105 | 2019-04-11 |
| 1780155648 | Eryn R Mcentee | Naturopath | 2216 Ne46th St, Seattle, WA 98105 | 2018-12-17 |
| 1356811921 | Kyle Leland Bernbach | Massage Therapist | 5224 Ravenna Ave Ne, Seattle, WA 98105 | 2018-11-27 |
| 1548742380 | Janal Kim | Physician Assistant | 4726 11th Ave Ne, Apt 511, Seattle, WA 98105 | 2018-08-29 |
| Find all providers in zip 98105 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376170878 | Andrew Crompton Yazman | Pediatrics | 4800 Sand Point Way, Ne Oc.7.830, Seattle, WA 98105 | 2020-03-25 |
| 1962964726 | Michael Arenson | Pediatrics | 4800 Sand Point Way Ne # Oc 7/8, Seattle, WA 98105-3901 | 2019-04-02 |
| 1083179154 | Sea - Mar Community Health Center | Pediatrics | 9635 Des Moines Memorial Dr, Seattle, WA 98108-5061 | 2019-02-04 |
| 1083119499 | Caroline Vandiver Jackson | Pediatrics | 4800 Sand Point Way Ne, O.c. 7.830, Seattle, WA 98105 | 2018-03-27 |
| 1356874689 | Emily Lauren Yang | Pediatrics | 4800 Sand Point Way Ne # Oc.7.830, Seattle, WA 98105-3901 | 2017-04-04 |
| 1932630266 | Paul Michael Morales | Pediatrics | 4800 Sand Point Way Ne # Oc7.830, Seattle, WA 98105-3901 | 2017-03-27 |
| 1366993297 | Steven Fox | Pediatrics | 4600 Ne 54th St, Seattle, WA 98105-2935 | 2016-10-15 |
| 1740675669 | Jeremy Ho Mun Chan | Pediatrics | 4800 Sand Point Way Ne Oc.7.830, Seattle, WA 98105 | 2015-03-30 |
| 1497147094 | Telehospitalist Services | Pediatrics | 3113 Ne 65th St, Seattle, WA 98115-7228 | 2015-02-19 |
| 1497160014 | Brianna Katherine Brei | Pediatrics | 1959 Ne Pacific St Box 356320, Seattle, WA 98195-3276 | 2014-06-23 |
| Find all providers in SEATTLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.