Active NPI
Dynacare Northwest, Inc.
- Clinical Medical Laboratory
- Seattle, WA
National Provider Identifier
1306280201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- DYNACARE NORTHWEST, INC.
- Practice address
- 1221 Madison Street
Suite 220
Seattle, WA 98104-4304 - Phone
- (206) 215-6131
- NPI assigned
- Apr 22, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kimberly Williams
- Title
- VP
- Phone
- (800) 222-7566
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
1221 Madison Street
Suite 220
Seattle, WA 98104-4304
Mailing address
PO Box 2240
Burlington, NC 27216-2240
Phone (800) 222-7566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50D0631626 | Other | CLIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| 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 |
Other NPIs on the same Medicare enrollment 27
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366588800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1387756800000",
"number": "1306280201",
"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": "1221 MADISON STREET",
"address_2": "SUITE 220",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981044304",
"telephone_number": "206-215-6131"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DYNACARE NORTHWEST, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-22",
"last_updated": "2013-12-23",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_title_or_position": "VP",
"authorized_official_telephone_number": "800-222-7566"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "50D0631626",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; 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.