Provider Demographics
NPI:1447473632
Name:UPMC WASHINGTON
Entity type:Organization
Organization Name:UPMC WASHINGTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-223-3548
Mailing Address - Street 1:95 LEONARD AVE
Mailing Address - Street 2:BLDG 2 THIRD FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3368
Mailing Address - Country:US
Mailing Address - Phone:724-223-3256
Mailing Address - Fax:724-229-2379
Practice Address - Street 1:95 LEONARD AVE
Practice Address - Street 2:BLDG 2 THIRD FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3368
Practice Address - Country:US
Practice Address - Phone:724-223-3256
Practice Address - Fax:724-229-2379
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC WASHINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-10
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207V00000X
PA230201261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PW1501525OtherUPMC FOR YOU
PA1007389110130Medicaid
PW1011734OtherGATEWAY
PW65681OtherUNISON
PW1011734OtherGATEWAY