| Details | Last Recertification Date | Update | Recertification | 5/6/2024 11:32:22 AM | 5/5/2025 12:31:56 PM | 5/5/2025 12:31 PM |
| Details | Nature of Support: Support Received From Date | Update | Change Request | 1/1/2020 12:00:00 AM | 1/1/2025 12:00:00 AM | 3/19/2025 11:26 AM |
| Details | Nature of Support: Support Received To Date | Update | Change Request | 12/31/2024 12:00:00 AM | 12/31/2029 12:00:00 AM | 3/19/2025 11:26 AM |
| Details | Nature of Support: Support Received From Date | Update | Change Request | 1/1/2020 12:00:00 AM | 1/1/2025 12:00:00 AM | 3/19/2025 11:26 AM |
| Details | Nature of Support: Support Received To Date | Update | Change Request | 12/31/2024 12:00:00 AM | 12/31/2029 12:00:00 AM | 3/19/2025 11:26 AM |
| Details | Grant Number | Update | Group Change Request | NU52PS910221 | NU52PS910277 | 3/18/2025 12:03 PM |
| Details | NOFO Number | Update | Group Change Request | CDC-RFA-PS20-2001 | CDC-RFA-PS25-0003 | 3/18/2025 12:03 PM |
| Contacts | Primary Contact | Update | Profile Change Request | Novak, Justina M
TB Process Improvment Coordinator
Washington State Dept of Health --TB Program
3602363728 | Novak, Justina M
TB Operations Lead
Washington State Dept of Health --TB Program
3608100211 | 6/3/2024 6:16 PM |
| Contacts | Authorizing Official | Update | Group Change Request | Pecha, Monica
TB Controller
Washington Department of Health
2064185544 | Hutton, Scott C
WA State TB Controller/TB Program Manager
WA State Dept of Health - TB Program
5642003178 | 6/3/2024 4:19 PM |
| Details | Nature of Support: In Kind Support Description | Update | Recertification | We receive 317 funding from the CDC-DTBE Cooperative Agreement for our TB program. We do not these use federal TB dollars to purchase 340B medications, nor do our LHJs, we use state or local funding. Occasionally we apply for expiring CDC National Stockpile TB medications. If we receive any of these former Stockpile TB medications, they are stored and tracked separately from the 340B TB medications. CDC also provided staffing during a Dept of Correction Outbreak this past year. | We receive 317 funding from the CDC-DTBE Cooperative Agreement for our TB program. We do not these use federal TB dollars to purchase 340B medications, nor do our LHJs, we use state or local funding. Occasionally we apply for expiring CDC National Stockpile TB medications. If we receive any of these former Stockpile TB medications, they are stored and tracked separately from the 340B TB medications. CDC may provide staffing assistance during large outbreaks. | 5/6/2024 11:32 AM |
| Details | Last Recertification Date | Update | Recertification | 5/24/2023 7:05:31 AM | 5/6/2024 11:32:22 AM | 5/6/2024 11:32 AM |
| Details | Nature of Support: In Kind Support Description | Update | Recertification | The Washington State TB Program receives 317 funding from the CDC Cooperative Agreement for our TB program. We do not these use federal TB dollars to purchase 340B medications, nor do our LHJs, we use state or local funding. Occasionally we apply for expiring CDC National Stockpile TB medications. If we receive any of these former Stockpile TB medications, they are stored and tracked separately from the 340B TB medications. | We receive 317 funding from the CDC-DTBE Cooperative Agreement for our TB program. We do not these use federal TB dollars to purchase 340B medications, nor do our LHJs, we use state or local funding. Occasionally we apply for expiring CDC National Stockpile TB medications. If we receive any of these former Stockpile TB medications, they are stored and tracked separately from the 340B TB medications. CDC also provided staffing during a Dept of Correction Outbreak this past year. | 5/24/2023 7:05 AM |
| Details | Last Recertification Date | Update | Recertification | 5/9/2022 12:23:17 PM | 5/24/2023 7:05:31 AM | 5/24/2023 7:05 AM |
| Details | Grant Number | Update | Recertification | 6NU52PS910221 | NU52PS910221 | 5/24/2023 7:05 AM |
| Details | Last Recertification Date | Update | Recertification | 5/6/2021 10:50:37 AM | 5/9/2022 12:23:17 PM | 5/9/2022 12:23 PM |
| Details | Grant Number | Update | Recertification | 5NU52PS910221-02-00 | 6NU52PS910221 | 5/9/2022 12:23 PM |
| Details | Nature of Support: Support Received From Date | Update | Recertification | | 1/1/2020 12:00:00 AM | 5/6/2021 10:50 AM |
| Details | Nature of Support: Support Received To Date | Update | Recertification | | 12/31/2024 12:00:00 AM | 5/6/2021 10:50 AM |
| Details | Nature of Support: In Kind Support Description | Update | Recertification | | The Washington State TB Program receives 317 funding from the CDC Cooperative Agreement for our TB program. We do not these use federal TB dollars to purchase 340B medications, nor do our LHJs, we use state or local funding. Occasionally we apply for expiring CDC National Stockpile TB medications. If we receive any of these former Stockpile TB medications, they are stored and tracked separately from the 340B TB medications. | 5/6/2021 10:50 AM |
| Details | Nature of Support: Support Received From Date | Update | Recertification | | 1/1/2020 12:00:00 AM | 5/6/2021 10:50 AM |
| Details | Nature of Support: Support Received To Date | Update | Recertification | | 12/31/2024 12:00:00 AM | 5/6/2021 10:50 AM |
| Details | Last Recertification Date | Update | Recertification | 5/28/2020 8:04:28 AM | 5/6/2021 10:50:37 AM | 5/6/2021 10:50 AM |
| Details | Grant Number | Update | Recertification | 6NU52PS910221-01-01 | 5NU52PS910221-02-00 | 5/6/2021 10:50 AM |
| Details | NOFO Number | Update | Recertification | | CDC-RFA-PS20-2001 | 5/6/2021 10:50 AM |
| Addresses | Main Address | Update | Recertification |
310 Israel Road SE
Tumwater, WA 98501 |
1610 NE 150th Street
MS K17-9
Shoreline, WA 98155 | 5/28/2020 8:04 AM |
| Details | Nature Of Support | Insert | Recertification | | In-Kind products or services (see note below; must have been purchased with section 317 funds) | 5/28/2020 8:04 AM |
| Details | Last Recertification Date | Update | Recertification | 5/14/2019 12:50:24 PM | 5/28/2020 8:04:28 AM | 5/28/2020 8:04 AM |
| Details | Grant Number | Update | Recertification | 5NU52PS004674-05-00 | 6NU52PS910221-01-01 | 5/28/2020 8:04 AM |
| Details | Entity Subname | Update | Recertification | | TB Program | 5/28/2020 8:04 AM |
| Details | Last Recertification Date | Update | Recertification | 5/10/2018 2:11:22 PM | 5/14/2019 12:50:24 PM | 5/14/2019 12:50 PM |
| Details | Grant Number | Update | Recertification | 6NU52PS04674-04-01 | 5NU52PS004674-05-00 | 5/14/2019 12:50 PM |
| Contacts | Authorizing Official | Update | Change Request | Carlson, Sherry
TB Controller
WA State Dept of Health
3602363528 | Pecha, Monica
TB Controller
Washington Department of Health
2064185544 | 6/28/2018 6:59 PM |
| Contacts | Primary Contact | Update | Recertification | Carlson, Sherry
TB Controller
WA State Dept of Health
3602363528 | Novak, Justina M
TB Process Improvment Coordinator
Washington State Dept of Health --TB Program
3602363728 | 5/10/2018 2:11 PM |
| Details | Last Recertification Date | Update | Recertification | 4/28/2017 12:00:00 AM | 5/10/2018 2:11:22 PM | 5/10/2018 2:11 PM |
| Details | Grant Number | Update | Recertification | 5NU52PS004674-03-00 | 6NU52PS04674-04-01 | 5/10/2018 2:11 PM |
| Contacts | Authorizing Official | Update | | Carlson, Sherry
TB Controller
3602363528 | Carlson, Sherry
TB Controller
WA State Dept of Health
3602363528 | 1/8/2018 10:36 AM |
| Contacts | Primary Contact | Update | | Carlson, Sherry
TB Controller
3602363528 | Carlson, Sherry
TB Controller
WA State Dept of Health
3602363528 | 1/8/2018 10:36 AM |
| Contacts | Authorizing Official | Update | | Allen, Sheanne
TB CONTROLLER
3602363423 | Carlson, Sherry
TB Controller
3602363528 | 5/17/2017 7:34 AM |
| Contacts | Primary Contact | Update | | Allen, Sheanne
TB CONTROLLER
3602363423 | Carlson, Sherry
TB Controller
3602363528 | 5/17/2017 7:34 AM |
| Addresses | Main Address | Insert | | |
310 Israel Road SE
Tumwater, WA 98501 | 4/28/2017 2:16 PM |
| Details | Last Recertification Date | Update | | 3/1/2016 12:00:00 AM | 4/28/2017 12:00:00 AM | 4/28/2017 2:16 PM |
| Details | Grant Number | Update | | TB-WA | 5NU52PS004674-03-00 | 4/28/2017 2:16 PM |
| Contacts | Authorizing Official | Insert | | | Allen, Sheanne
TB CONTROLLER
3602363423 | 6/3/2016 7:20 AM |
| Contacts | Primary Contact | Update | | FIELD, KIM
3602363447 | Allen, Sheanne
TB CONTROLLER
3602363423 | 6/3/2016 7:20 AM |
| Addresses | Shipping Address | Insert | | | Seattle King County Public Health Downtown Pharmacy
2124 4th Ave
Seattle, WA 98121 | 3/1/2016 10:45 AM |
| Details | Last Recertification Date | Update | | 2/5/2015 12:00:00 AM | 3/1/2016 12:00:00 AM | 3/1/2016 10:45 AM |
| Details | Nature Of Support | Insert | | | Direct Funding (dollars received from CDC or an intermediate organization) | 2/5/2015 9:24 AM |
| Details | Last Recertification Date | Update | | 2/10/2014 12:00:00 AM | 2/5/2015 12:00:00 AM | 2/5/2015 9:24 AM |
| Details | Last Recertification Date | Update | | 1/1/2012 12:00:00 AM | 2/10/2014 12:00:00 AM | 2/10/2014 11:09 AM |
| Details | Comments Public | Insert | | | 03/23/2012 changed address (main address added and existing data moved to billing address block); 12/11/06 UPDATED ADDR (WAS PO BOX 47990); 11/12/05 UPDATED ADDR(WAS 7211 CLEAN WATER LANE, NEW MARKET INDUSTRIAL CAM) | 3/23/2012 1:37 PM |
| Details | Last Recertification Date | Update | | 1/1/2011 12:00:00 AM | 1/1/2012 12:00:00 AM | 11/7/2011 4:51 PM |
| Contacts | Primary Contact | Insert | | | FIELD, KIM
3602363447 | 10/22/2010 6:41 PM |
| Details | Last Recertification Date | Insert | | | 1/1/2011 12:00:00 AM | 10/22/2010 6:41 PM |
| Details | Grant Number | Insert | | | TB-WA | 10/22/2010 6:41 PM |
| Details | 340B ID | Insert | | | TB985047 | 10/22/2010 6:41 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 10/22/2010 6:41 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 10/22/2010 6:41 PM |
| Details | Medicare Provider Number | Insert | | | | 10/22/2010 6:41 PM |
| Details | Entity Name | Insert | | | WASHINGTON STATE DEPARTMENT OF HEALTH | 10/22/2010 6:41 PM |
| Details | Program Code | Insert | | | TB | 10/22/2010 6:41 PM |
| Details | Entity Subname | Insert | | | | 10/22/2010 6:41 PM |
| Dates | Participating Approval Date | Insert | | | 11/12/2004 12:00:00 AM | 10/22/2010 6:41 PM |
| Details | State | Insert | | | Active | 10/22/2010 6:41 PM |
| Dates | Registration Date | Insert | | | 1/1/2001 12:00:00 AM | 10/22/2010 6:41 PM |
| Dates | Signed By Date | Insert | | | 1/1/2011 12:00:00 AM | 10/22/2010 6:41 PM |
| Dates | Start Date | Insert | | | 1/1/2001 12:00:00 AM | 10/22/2010 6:41 PM |
| Terminations | Termination Comments | Insert | | | | 10/22/2010 6:41 PM |
| Terminations | Termination Date | Insert | | | | 10/22/2010 6:41 PM |
| Terminations | Termination Effective Date | Insert | | | | 10/22/2010 6:41 PM |
| Terminations | Termination Reason | Insert | | | | 10/22/2010 6:41 PM |
| Details | Comments Public | Insert | | | 12/11/06 UPDATED ADDR (WAS PO BOX 47990); 11/12/05 UPDATED ADDR(WAS 7211 CLEAN WATER LANE, NEW MARKET INDUSTRIAL CAM) | 10/22/2010 6:41 PM |