NPIMap

Organization Active NPI

Puget Sound Institute of Pathology PLLC

  • Anatomic Pathology Physician
  • Seattle, WA
National Provider Identifier
1992787030
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
CLIA 5000633091 Issued in WA
Legal business name
PUGET SOUND INSTITUTE OF PATHOLOGY PLLC
Practice address
1001 Klickitat Way SW #205
Puget Sound Institute of Pathology
Seattle, WA 98134
Phone
(206) 622-7747
Fax
(206) 467-1470
NPI assigned
Nov 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Authorized official

Name
Kenneth A Meckler, MD
Title
Managing Partner
Phone
(206) 622-7747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0101X CLIA 5000633091 WA Primary

Addresses

Primary practice location

1001 Klickitat Way SW #205
Puget Sound Institute of Pathology
Seattle, WA 98134

Mailing address

PO Box 34245
Psip PLLC
Seattle, WA 98124-1245
Phone (206) 622-7747

Other identifiers 3

IdentifierTypeStateIssuer
161839OtherWADEPT OF LABOR INDUSTRIES
81407OtherWADEPT OF LABOR INDUSTRIES
7066947MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1992787030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34245",
            "address_2": "PSIP PLLC",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241245",
            "telephone_number": "206-622-7747",
            "fax_number": "206-467-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 KLICKITAT WAY SW #205",
            "address_2": "PUGET SOUND INSTITUTE OF PATHOLOGY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98134",
            "telephone_number": "206-622-7747",
            "fax_number": "206-467-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND INSTITUTE OF PATHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "MECKLER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "206-622-7747",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": "WA",
            "license": "CLIA 5000633091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR INDUSTRIES",
            "identifier": "161839",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR INDUSTRIES",
            "identifier": "81407",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7066947",
            "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 Jul 2, 2012; 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.