Dynacare Northwest Inc
Organization Active NPI Clinical Medical Laboratory · Sumner, WA
NPI 1992938286 · NPPES record last updated Sep 2, 2009
Key facts
- NPI
- 1992938286
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- DYNACARE NORTHWEST INC
- Practice address
- 5814 Graham Ave
Ste 100
Sumner, WA 98390-2728 - Phone
- (253) 862-8740
- NPI assigned
- Sep 2, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. William B Hayes
- Title
- Cfo Evp Treasurer
- Phone
- (800) 222-7566
Other NPIs on the same Medicare enrollment 27
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
5814 Graham Ave
Ste 100
Sumner, WA 98390-2728
Mailing address
PO Box 2240
Burlington, NC 27216-2240
Phone (800) 222-7566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50D0969029 | Other | CLIA |
Other providers in Sumner, WA
- Alicia Culp
- Benigno Waldo A Dagan
- Rendall Davis
- Donald Waymon Dennis Jr.
- Tessa Dunbar
- Rolf Melker Edlund
- Annbell Edmond
- Jennifer Marie Elton
- Sally Mae Ericksen
- Joel Alejandro Estrada
All providers in Sumner, WA · Clinical Medical Laboratory in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.