NPIMap

Organization Active NPI

Dynacare Northwest, Inc

  • Clinical Medical Laboratory
  • Seattle, WA
National Provider Identifier
1477530483
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
DYNACARE NORTHWEST, INC
Practice address
550 17TH Ave
Suite 310
Seattle, WA 98122
Phone
(206) 861-7000
NPI assigned
Dec 30, 2005
Last updated
Dec 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

550 17TH Ave
Suite 310
Seattle, WA 98122

Mailing address

PO Box 14954
Seattle, WA 98114-0954
Phone (206) 861-7000

Other identifiers 1

IdentifierTypeStateIssuer
50D0632667OtherWACLIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

View all 27

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387756800000",
    "number": "1477530483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14954",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981140954",
            "telephone_number": "206-861-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 17TH AVE",
            "address_2": "SUITE 310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98122",
            "telephone_number": "206-861-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNACARE NORTHWEST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-30",
        "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": "50D0632667",
            "state": "WA"
        }
    ],
    "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.

Verify at the official NPI Registry.