NPIMap

Organization Active NPI

Cellnetix Labs LLC

  • Clinical Medical Laboratory
  • Everett, WA
National Provider Identifier
1063481570
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CELLNETIX LABS LLC
Practice address
1321 Colby Avenue
Everett, WA 98206
Phone
(425) 261-3670
Fax
(425) 261-3676
NPI assigned
Mar 16, 2006
Last updated
Dec 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Authorized official

Name
Donald Raymond Howard, MD PHDNPI 1578522603
Title
Chief Operating Officer
Phone
(206) 386-2676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1321 Colby Avenue
Everett, WA 98206

Mailing address

PO Box 94344
Seattle, WA 98124-6644
Phone (206) 386-2676

Other identifiers 1

IdentifierTypeStateIssuer
7129968MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051116000963 WA Part B Supplier - Independent Clinical Laboratory 7012936206 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Olympia, WA; Spokane, WA; Tukwila, WA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cellnetix Labs LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

2490 S Woodworth Loop
Ste 410
Palmer, AK 99645
Phone (807) 745-8100

1912 Everett Ave
Everett, WA 98201
Phone (206) 259-5141

2918 Colby Ave
Ste 101
Everett, WA 98201
Phone (425) 259-5141

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1063481570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94344",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246644",
            "telephone_number": "206-386-2676",
            "fax_number": "206-386-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVENUE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98206",
            "telephone_number": "425-261-3670",
            "fax_number": "425-261-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELLNETIX LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "206-386-2676",
        "authorized_official_credential": "MD PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7129968",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.