Diagnostic Vascular Laboratory, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

DIAGNOSTIC VASCULAR LABORATORY, LLC

Practice address

3911 Castlevale Rd
Suite 105
Yakima, WA 98902-7807

Phone

(509) 575-7652

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Susan Youngstrom

Title

MGR

Phone

(509) 575-7652

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carl Youngstrom, MD

  • Surgery Physician
  • Yakima, WA
  • NPI 1780772434
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1023154465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 CASTLEVALE RD",
            "address_2": "SUITE 105",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 CASTLEVALE RD",
            "address_2": "SUITE 105",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027807",
            "telephone_number": "509-575-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC VASCULAR LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "YOUNGSTROM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "509-575-7652",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7017049",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin M Dewey, LMP
• Zoe Lehn Dewitte
• Amrit K Dhanota, M.D.
• Deepak K Dhruva, RPH
• Jessica Di Nizio, D.O.
• Karen Diana, APRN
• Luz Maria Diaz Arroyo, SC61603334
• Paola Diaz Franco
• Ernestina Diaz, RN
• Feliz D Diaz, CRNA

• Physiological Laboratory in Yakima, WA
• Providers in Yakima, WA by specialty
• Physiological Laboratory in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.