Northwest Clinical Nutrition Center Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

6006101999 Issued in WA

Legal business name

NORTHWEST CLINICAL NUTRITION CENTER INC

Practice address

2611 NE 125TH St Ste 90
Suite 208
Seattle, WA 98125-4357

Phone

(206) 362-0035

Fax

(206) 362-6927

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert A Kanter, MD

Title

Director

Phone

(206) 362-0035

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428278400000",
    "number": "1033238472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 NE 125TH ST STE 90",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254357",
            "telephone_number": "206-592-5000",
            "fax_number": "206-824-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 NE 125TH ST STE 90",
            "address_2": "SUITE 208",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254357",
            "telephone_number": "206-362-0035",
            "fax_number": "206-362-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CLINICAL NUTRITION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2015-04-06",
        "status": "A",
        "authorized_official_last_name": "KANTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "206-362-0035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WA",
            "license": "6006101999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Medical Laboratory in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; 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.