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PED503300-28 SEATTLE CHILDREN'S HOSPITAL (Active)
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Main Details
Name
SEATTLE CHILDREN'S HOSPITAL
Subdivision Name
North Clinic
Type
Children's Hospital
Rural
No
340B ID
PED503300-28
Medicare Provider Number
503300
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2019
Participating Start Date
7/1/2019
Participating Approval Date
5/2/2019
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
1815 13TH ST
EVERETT, WA 98201-1679
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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