Dynacare Northwest Inc.
Organization Active NPI Clinical Medical Laboratory · Issaquah, WA
NPI 1033374236 · NPPES record last updated Dec 23, 2013
Key facts
- NPI
- 1033374236
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- DYNACARE NORTHWEST INC.
- Practice address
- 450 NW Gilman Blvd Ste 101
Issaquah, WA 98027-2483 - Phone
- (425) 391-0752
- NPI assigned
- Jul 28, 2008
- Organization subpart
- No
Authorized official
- Name
- Kimberly Williams
- Title
- VP
- Phone
- (800) 222-7566
Other NPIs on the same Medicare enrollment 27
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040217000665 | WA | Part B Supplier - Independent Clinical Laboratory | 5597650788 |
28 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Issaquah, WA; Redmond, WA; Seattle, WA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
450 NW Gilman Blvd Ste 101
Issaquah, WA 98027-2483
Mailing address
PO Box 2240
Burlington, NC 27216-2240
Phone (800) 222-7566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50D1017881 | Other | CLIA |
Other names
- Issaquah Stat Lab
Other providers in Issaquah, WA
- Chiwon Dunlap
- Carley Dunn
- Mylien Thi Duong
- Daniel T Duryea
- Dynacare Northwest Inc
- Dynacare Northwest, Inc
- Dynamic Nutrition NW LLC
- E. McKay Tingey DDS Ms PC
- E. Polsky DDS & B. Virk DMD MSD, PLLC
- Alexandria C. Easter
All providers in Issaquah, WA · Clinical Medical Laboratory in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.