NPIMap

Organization Active NPI

Pacific Vascular Incorporated

  • Physiological Laboratory
  • Kennewick, WA
National Provider Identifier
1023932944
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
PACIFIC VASCULAR INCORPORATED
Practice address
3321 W Kennewick Ave Ste 230
Kennewick, WA 99336-2957
Phone
(509) 591-9094
Fax
(425) 486-8976
NPI assigned
Aug 5, 2026
Last updated
Oct 15, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
PACIFIC VASCULAR INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Authorized official

Name
Bonnie Brown, RVT
Title
Ceo
Phone
(425) 398-7781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

3321 W Kennewick Ave Ste 230
Kennewick, WA 99336-2957

Mailing address

11714 N Creek Pkwy N Ste 100
Bothell, WA 98011-8099
Phone (425) 486-8868

Other identifiers 1

IdentifierTypeStateIssuer
7015852MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Pacific Vascular16 organizations share this tax ID, including this one
Part of
Pacific Vascular

Other organizations with this tax ID 15

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

View all 15

Locations

3321 W Kennewick Ave
Ste 230
Kennewick, WA 99336
Phone (509) 591-9094

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1785888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1023932944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11714 N CREEK PKWY N STE 100",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118099",
            "telephone_number": "425-486-8868",
            "fax_number": "425-486-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3321 W KENNEWICK AVE STE 230",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362957",
            "telephone_number": "509-591-9094",
            "fax_number": "425-486-8976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC VASCULAR INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFIC VASCULAR INCORPORATED",
        "enumeration_date": "2026-08-05",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-398-7781",
        "authorized_official_credential": "RVT"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7015852",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; 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.