Active NPI
Dynacare Northwest Inc
- Clinical Medical Laboratory
- Seattle, WA
National Provider Identifier
1508199597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- DYNACARE NORTHWEST INC
- Practice address
- 3400 California Ave SW
Ste 300
Seattle, WA 98116-3307 - Phone
- (206) 320-5519
- NPI assigned
- Sep 9, 2009
- Last updated
- Dec 23, 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 | NU | Primary |
Addresses
Primary practice location
3400 California Ave SW
Ste 300
Seattle, WA 98116-3307
Mailing address
PO Box 2240
Burlington, NC 27216-2240
Phone (800) 222-7566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50D1022470 | 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.
-
dba Pac Med Clinics Lynnwood
- Clinical Medical Laboratory
- Lynnwood, WA
- NPI 1275798407
O20040217000665
-
dba Swedish Family Medicine
- Clinical Medical Laboratory
- Seattle, WA
- NPI 1710143557
O20040217000665
-
dba Olympia Black Hills
- Clinical Medical Laboratory
- Olympia, WA
- NPI 1811152028
O20040217000665
National Provider Directory
National Provider DirectoryLocations
3400 California Ave SW
Ste 300
Seattle, WA 98116
Phone (206) 320-3399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252454400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1387756800000",
"number": "1508199597",
"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": "3400 CALIFORNIA AVE SW",
"address_2": "STE 300",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981163307",
"telephone_number": "206-320-5519"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DYNACARE NORTHWEST INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-09-09",
"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": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "50D1022470",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
- Dynacare Northwest Inc (Pac Med Clinics Beacon Hill)
- Dynacare Northwest Inc (Pac Med Clinics Northgate)
- Dynacare Northwest Inc (Swedish Ballard)
- Dynacare Northwest Inc (SP Queen Anne)
- Dynacare Northwest Inc (Health Care for Women)
- Dynacare Northwest Inc
- Dynacare Northwest Inc (Swedish Family Medicine)
- Dynacare Northwest Inc (Seattle Cardiology)
- Dynacare Northwest Inc. (Hawthorne hills)
- Dynacare Northwest, Inc
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.