NPIMap

Organization Active NPI

Washington Gastroenterology PLLC

Doing business as Washington Gastroenterology Lab

  • Clinical Medical Laboratory
  • Federal Way, WA
National Provider Identifier
1467011122
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
WASHINGTON GASTROENTEROLOGY PLLC
Doing business as
Washington Gastroenterology Lab
Practice address
33915 1St Way S Ste 203
Federal Way, WA 98003-6396
Phone
(253) 838-9839
Fax
(253) 661-9077
NPI assigned
Jun 6, 2019
Last updated
May 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
WASHINGTON GASTROENTEROLOGY PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Nicholas Goralsky
Title
Chief Operating Officer
Phone
(253) 383-8342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

33915 1St Way S Ste 203
Federal Way, WA 98003-6396

Mailing address

PO Box 3006
Tacoma, WA 98401-3006
Phone (800) 734-6855

Other practice location 1

2202 S Cedar St Ste 340
Tacoma, WA 98405-2318
Phone (253) 503-2559

Other names 1

  • Washington Gastroenterology Lab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190125002591 WA Part B Supplier - Independent Clinical Laboratory 6204194848 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Federal Way, WA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Washington Gastroenterology

Locations

21616 76th Ave W
Ste 211
Edmonds, WA 98026
Phone (206) 782-7441

33915 1st Way S
Ste 203
Federal Way, WA 98003
Phone (253) 838-9839

2727 Hollycroft St
Ste 380
Gig Harbor, WA 98335
Phone (253) 858-0112

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

11216 Sunrise Blvd E
Ste 3207
Puyallup, WA 98374
Phone (253) 272-8148

Practitioners & affiliated clinicians

Practitioners 165

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.

View all 165

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1467011122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3006",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984013006",
            "telephone_number": "800-734-6855",
            "fax_number": "253-404-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33915 1ST WAY S STE 203",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036396",
            "telephone_number": "253-838-9839",
            "fax_number": "253-661-9077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2202 S Cedar St Ste 340",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984052318",
            "country_code": "US",
            "telephone_number": "253-503-2559",
            "fax_number": "253-503-2519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WASHINGTON GASTROENTEROLOGY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTON GASTROENTEROLOGY PLLC",
        "enumeration_date": "2019-06-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "GORALSKY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "253-383-8342"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Gastroenterology Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Washington Gastroenterology Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.