NPIMap

Organization Active NPI

Fred Hutchinson Cancer Center

  • Community/Retail Pharmacy
  • Seattle, WA
National Provider Identifier
1356415699
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00056846 Issued in WA
Legal business name
FRED HUTCHINSON CANCER CENTER
Practice address
825 Eastlake Ave E
G5900
Seattle, WA 98109-1023
Phone
(206) 288-1375
Fax
(206) 288-1380
NPI assigned
Nov 20, 2006
Last updated
Jan 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
FRED HUTCHINSON CANCER CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donna Barry
Title
Pharmacy Manager
Phone
(206) 606-4358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CF00056846 WA Primary

Addresses

Primary practice location

825 Eastlake Ave E
G5900
Seattle, WA 98109-1023

Mailing address

825 Eastlake Ave E
G5900
Seattle, WA 98109-1023
Phone (206) 606-6500

Other identifiers 2

IdentifierTypeStateIssuer
4928694OtherNCPDP
6024046MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031008000041 WA Part A Provider - Hospital 7911819891 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Poulsbo, WA; Seattle, WA; Issaquah, WA; Kirkland, WA; Bellevue, WA
O20100930037239 WA DME Supplier - PharmacyDME Supplier - Hospital 7911819891 Practice locations: Seattle, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356415699. Details of each certification follow.

Hospital certification: CCN 500138

Legal name
FRED HUTCHINSON CANCER CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Nov 9, 1984
Last certification
Oct 30, 2025
Beds
20
Ownership / control type
Other
Most recent change of ownership
Jan 1, 2001 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jun 16, 1998 in WA
Enrollment address
825 Eastlake Ave E
Seattle, WA 98109-4405
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Other

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Fred Hutchinson Cancer Center825 Eastlake Ave E, Seattle, WA 98109-4405(206) 606-1375 Immunosuppressive Drugs|Oral Anticancer Drugs Does not accept assignmentParticipating since Oct 2, 2001

National Provider Directory

National Provider Directory
Part of
Fred Hutchinson Cancer Center

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

825 Eastlake Ave E
#200
Seattle, WA 98109

825 Eastlake Ave E
#600
Seattle, WA 98109

825 Eastlake Ave E
#G5900
Seattle, WA 98109
Phone (206) 288-1375

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathy Surace-Smith Individual Corporate Director Apr 1, 2022
Sean Boyle Individual Corporate Director Apr 1, 2022
Thomas J Lynch Individual Corporate Officer Apr 1, 2022
Corporate Director Apr 1, 2020
W-2 Managing Employee Apr 1, 2022
Nicole Robinson Individual Corporate Officer Apr 1, 2022
Michelle Seitz Individual Corporate Director Sep 1, 2024
Cheryl M Scott Individual Corporate Director Apr 18, 2024
David Browdy Individual Corporate Officer Apr 1, 2022
Stephen Graham Individual Corporate Director Apr 1, 2022
Richard Anderson Individual Corporate Director Jan 24, 2024
Timothy H Dellit Individual Corporate Director Jul 1, 2022
Joanne Harrell Individual Corporate Director Apr 1, 2022
Steven Haydon Individual Corporate Officer Apr 1, 2022
Nancy E Davidson Individual Corporate Director Apr 1, 2022
W-2 Managing Employee Dec 1, 2016
Herbert Bone Individual Corporate Director Apr 1, 2022
Leigh Morgan Individual Corporate Director Apr 1, 2022
Christopher Bundesmann Individual Corporate Officer Apr 1, 2022
Jeremy Jaech Individual Corporate Director Apr 1, 2022
Julie Anne Nordstrom Individual Corporate Director Apr 1, 2022
Eduardo Penalver Individual Corporate Director Apr 1, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 933

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 933

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1356415699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 EASTLAKE AVE E",
            "address_2": "G5900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981091023",
            "telephone_number": "206-606-6500",
            "fax_number": "206-606-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EASTLAKE AVE E",
            "address_2": "G5900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981091023",
            "telephone_number": "206-288-1375",
            "fax_number": "206-288-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED HUTCHINSON CANCER CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRED HUTCHINSON CANCER CENTER",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "206-606-4358"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00056846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4928694",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6024046",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.