Provider Demographics
NPI:1548272453
Name:NORTHWEST CENTER FOR CONGENITAL HEART DISEASE
Entity type:Organization
Organization Name:NORTHWEST CENTER FOR CONGENITAL HEART DISEASE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HRAIR
Authorized Official - Middle Name:ANTRANIG
Authorized Official - Last Name:GARABEDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-747-6707
Mailing Address - Street 1:101 W 8TH AVE
Mailing Address - Street 2:SUITE 4300
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2307
Mailing Address - Country:US
Mailing Address - Phone:509-747-6707
Mailing Address - Fax:509-624-9186
Practice Address - Street 1:101 W 8TH AVE
Practice Address - Street 2:SUITE 4300
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2307
Practice Address - Country:US
Practice Address - Phone:509-747-6707
Practice Address - Fax:509-624-9186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213519Medicaid
0194170OtherL & I
WA7042328Medicaid
WA8855732Medicare ID - Type Unspecified