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PED503300-04 SEATTLE CHILDREN'S HOSPITAL (Active)
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Main Details
Name
SEATTLE CHILDREN'S HOSPITAL
Subdivision Name
Seattle Children's South Sound Cardiology Clinic- at Cedar
Type
Children's Hospital
Rural
No
340B ID
PED503300-04
Medicare Provider Number
503300
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/7/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/8/2024
Last Recertification Date
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
1901 S CEDAR ST STE 103
TACOMA, WA 98405-2302
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2015, terminated 4/1/2016. Reinstated 1/1/2025.
10/08/2024
7/30/15 Participated starting 9/29/10, terminated 1/1/11 at the request of covered entity, reinstated based on new registration submitted in July 2015
07/30/2015
May 2025
May 2025
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