Eastside Fertility Lab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

MTS-1269 Issued in WA

Legal business name

EASTSIDE FERTILITY LAB INC

Practice address

1370 116TH Ave NE
Ste 202
Bellevue, WA 98004

Phone

(425) 454-8018

Fax

(425) 635-0742

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

James I Kustin, MD

Title

Owner

Phone

(425) 688-7740

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689731945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 116TH AVE NE",
            "address_2": "STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-462-6100",
            "fax_number": "425-635-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 116TH AVE NE",
            "address_2": "STE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-454-8018",
            "fax_number": "425-635-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE FERTILITY LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUSTIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-688-7740",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WA",
            "license": "MTS-1269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastside Birth Center, PS
• Eastside Chiropractic Group a Professional Service Corporation
• Eastside Dermatology Inc PS
• Eastside Endocrinology and Diabetes, PS
• Eastside Family Medicine Clinic
• Eastside Integrative Health
• Eastside Internal Medicine & Cardiology David B Ferrin MD
• Eastside Massage Clinic, Inc.
• Eastside Oasis Day Spa & Massage Therapy LLC
• Eastside Oral Surgery Associates

• Clinical Medical Laboratory in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Clinical Medical Laboratory in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.