Northwest Vascular Lab PLLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

4363 Issued in WA

Legal business name

NORTHWEST VASCULAR LAB PLLC

Practice address

3104 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1936

Phone

(360) 733-8128

Fax

(360) 733-5354

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

John Obrien, RVT

Title

Technical Director

Phone

(360) 733-8128

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1154438000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 SQUALICUM PKWY",
            "address_2": "SUITE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251936",
            "telephone_number": "360-733-8128",
            "fax_number": "360-733-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 SQUALICUM PKWY",
            "address_2": "SUITE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251936",
            "telephone_number": "360-733-8128",
            "fax_number": "360-733-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST VASCULAR LAB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "OBRIEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "TECHNICAL DIRECTOR",
        "authorized_official_telephone_number": "360-733-8128",
        "authorized_official_credential": "RVT"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "WA",
            "license": "4363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emily Kristine Norton, DPT
• Tracy Lynn Norvell, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.