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PED503300-02 SEATTLE CHILDREN'S HOSPITAL (Active)
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Main Details
Name
SEATTLE CHILDREN'S HOSPITAL
Subdivision Name
OLYMPIA CLINIC
Type
Children's Hospital
Rural
No
340B ID
PED503300-02
Medicare Provider Number
503300
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
9/29/2010
Participating Start Date
7/1/2013
Participating Approval Date
6/28/2013
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Seattle Children's Hospital
Warren E Hewitt, VP, Finance and Chief Accounting Officer
(206) 884-2378
Primary Contact
Seattle Children's Hospital
Joanne Donhoff, Senior Reimbursement Analyst
(206) 884-2345
Addresses
Street Address
615 LILLY ROAD NE
SUITE 140
OLYMPIA, WA 98506
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/24/13 participating 9/29/10 thru 3/31/12, not participating 4/1/12 thru 6/30/13, re-instated effective 7/1/13 based on a new registration submitted;
06/24/2013
2/28/12 Site terminated, effective 4/1/12
02/28/2012
May 2025
May 2025
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