NPIMap

Organization Active NPI

Cytolab Pathology Services Inc PS

  • Anatomic Pathology & Clinical Pathology Physician
  • Lynnwood, WA
National Provider Identifier
1568426575
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD00012785 Issued in WA
Legal business name
CYTOLAB PATHOLOGY SERVICES INC PS
Practice address
6825 216TH St SW
Lynnwood, WA 98036-7379
Phone
(425) 712-8020
Fax
(425) 712-8349
NPI assigned
Apr 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Authorized official

Name
Dr. Donold Samuel Nakonechny, M.D.
Title
President
Phone
(425) 712-8020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZC0500X MD00012785 WA
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X MD00012785 WA Primary

Addresses

Primary practice location

6825 216TH St SW
Lynnwood, WA 98036-7379

Mailing address

PO Box 100559
Florence, SC 29501-0559
Phone (843) 664-4300

Other identifiers 2

IdentifierTypeStateIssuer
12538OtherWABCBS
7015084MedicaidWA

National Provider Directory

National Provider Directory

Locations

6825 216th St SW
Ste E
Lynnwood, WA 98036
Phone (425) 712-8020

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1568426575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100559",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295010559",
            "telephone_number": "843-664-4300",
            "fax_number": "843-664-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6825 216TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367379",
            "telephone_number": "425-712-8020",
            "fax_number": "425-712-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYTOLAB PATHOLOGY SERVICES INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "NAKONECHNY",
        "authorized_official_first_name": "DONOLD",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-712-8020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": "WA",
            "license": "MD00012785",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD00012785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12538",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7015084",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.