NPIMap

Organization Active NPI

Dynacare Northwest Inc

Doing business as Pac Med Clinics - Totem Lake

  • Clinical Medical Laboratory
  • Kirkland, WA
National Provider Identifier
1184889305
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
DYNACARE NORTHWEST INC
Doing business as
Pac Med Clinics - Totem Lake
Practice address
12910 Totem Lake Blvd NE
Kirkland, WA 98034-2954
Phone
(425) 814-5000
NPI assigned
Jul 28, 2008
Last updated
Jul 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
Mr. William B Hayes
Title
Cfo Evp Treasurer
Phone
(800) 222-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

12910 Totem Lake Blvd NE
Kirkland, WA 98034-2954

Mailing address

PO Box 2240
Burlington, NC 27216-2240
Phone (800) 222-7566

Other identifiers 1

IdentifierTypeStateIssuer
50D0630365OtherCLIA

Other names 1

  • Pac Med Clinics - Totem Lake Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2198692Pacific Medical Centers , Totem Lake12910 Totem Lake Blvd Ste 101, Kirkland, WA 98034Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Dynacare Northwest Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

12910 Totem Lake Blvd NE
Kirkland, WA 98034
Phone (425) 814-5000

Practitioners & affiliated clinicians

Practitioners 1

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": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1184889305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2240",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272162240",
            "telephone_number": "800-222-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12910 TOTEM LAKE BLVD NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342954",
            "telephone_number": "425-814-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNACARE NORTHWEST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO EVP TREASURER",
        "authorized_official_telephone_number": "800-222-7566",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "50D0630365",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pac Med Clinics - Totem Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.