NPIMap

Organization Active NPI

University of Washington

Doing business as UW Medicine South Lake Union Pharmacy

  • Community/Retail Pharmacy
  • Seattle, WA
National Provider Identifier
1457904625
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
UNIVERSITY OF WASHINGTON
Doing business as
UW Medicine South Lake Union Pharmacy
Practice address
750 Republican St BLDG F
Seattle, WA 98109-4766
Phone
(206) 520-8380
Fax
(206) 598-8334
NPI assigned
Jul 17, 2019
Last updated
Mar 24, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF WASHINGTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Authorized official

Name
Steve Fijalka
Title
Chief Pharmacy Officer
Phone
(206) 744-3377

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

750 Republican St BLDG F
Seattle, WA 98109-4766

Mailing address

1959 NE Pacific St # 356015
Seattle, WA 98195-0001
Phone (206) 598-6059

Other names 1

  • UW Medicine South Lake Union Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081113000145 WA Part B Supplier - Mass Immunization (Roster Biller Only) 3274445150 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seattle, WA; Bellevue, WA

Other NPIs on the same Medicare enrollment 4

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2166534Uw Medicine Primary Care South Lake Union Clinic750 Republican St BLDG F FL 2, Seattle, WA 98109Provider-performed microscopyApr 4, 2028
50D2166580Uw Medicine South Lake Union750 Republican St, Seattle, WA 98109Certificate of waiverApr 4, 2028
50D2170091Uw Medicine Diabetes Institute South Lake Union750 Republican St Ms 358064, Seattle, WA 98109Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
U of W Speech Hear CL48 organizations share this tax ID, including this one
Part of
U of W Speech Hear CL

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Member organizations 7

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1457904625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST # 356015",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-598-6059",
            "fax_number": "206-598-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 REPUBLICAN ST BLDG F",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094766",
            "telephone_number": "206-520-8380",
            "fax_number": "206-598-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WASHINGTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF WASHINGTON",
        "enumeration_date": "2019-07-17",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "FIJALKA",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "206-744-3377"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UW Medicine South Lake Union Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UW Medicine South Lake Union Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.