PUGET SOUND KIDNEY CENTERS (NPI# 1073939062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073939062 |
| Entity Type | Organization |
| Organization Name | PUGET SOUND KIDNEY CENTERS |
| Other Organization Name | PSKC ANACORTES |
| Practice Address |
809 31st St Anacortes WA 98221 |
| Mailing Address |
1019 Pacific Ave Everett WA 98201-4148 |
| Practice Telephone | 3607553586 |
| Practice Fax Number | 3609822693 |
| Mailing Telephone | 4252595195 |
| Mailing Fax Number | 4252594860 |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2015-02-04 |
| Authorized Official Name | HAROLD S KELLY (PRESIDENT AND CEO) |
| Authorized Official Telephone | 4252595195 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
600401431 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2036232 | 05 | |
| WA | MEDICARE ID-TYPE UNSPECIFIED | 50-2573 | 01 |
| Other Name | Type Code |
|---|---|
| PSKC Anacortes | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1528478609 | Puget Sound Kidney Centers | Clinic/Center | 18121 149th Street Se, Monroe, WA 98272 | 2014-04-29 |
| 1093835811 | Puget Sound Kidney Centers | Clinic/Center | 21309 44th Ave W, Mountlake Terrace, WA 98043-3507 | 2007-03-29 |
| 1295855013 | Puget Sound Kidney Centers | Clinic/Center | 430 Se Midway Blvd, Oak Harbor, WA 98277-5017 | 2007-03-29 |
| 1386764009 | Puget Sound Kidney Centers | Clinic/Center | 18828 Smokey Point Blvd, Arlington, WA 98223-8266 | 2007-03-29 |
| 1053357434 | Puget Sound Kidney Centers | Clinic/Center | 1005 Pacific Ave, Everett, WA 98201-4148 | 2006-06-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PUGET SOUND KIDNEY CENTERS | 1019 Pacific Ave, Everett, WA 98201-4148 |
| Street Address |
809 31ST ST |
| City | ANACORTES |
| State | WA |
| Zip Code | 98221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295272573 | Kacey Roach | Dietitian, Registered | 809 31st St, Anacortes, WA 98221-3401 | 2017-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760035703 | Amber Upchurch | Behavioral Analyst | 2405 28thst, Anacortes, WA 98221 | 2019-07-18 |
| 1508329475 | Sean Elby Kasperbauer-mccool | Massage Therapist | 1010 6th St., Suite A, Anacortes, WA 98221 | 2019-04-09 |
| 1558843524 | Caitlyn Kimble Crowder | Physical Therapist | 1610 Commercial Ave Ste 1-a, Anacortes, WA 98221 | 2018-09-05 |
| 1740731819 | Stanojka Norma Stuart | Speech-Language Pathologist | 6837 Deer Lane, Anacortes, WA 98221 | 2016-10-24 |
| 1447638853 | Island Behavioral Medicine, Ps | Counselor | 3208 K Ave, Anacortes, WA 98221 | 2015-05-18 |
| 1972903615 | Clarence Hugh Jonson | Specialist | 6818 Gibralter Place, Anacortes, WA 98221 | 2014-08-29 |
| 1104161066 | Nancy J. Schafer | Speech-Language Pathologist | 2200 M Avenue, Anacortes, WA 98221 | 2012-12-04 |
| 1063766053 | Ingrid K. Larson Thieman | Pharmacist | 9080 S March Pt Road B4, Anacortes, WA 98221 | 2012-10-30 |
| 1265793723 | Elga Kinnear | Psychologist | 1019 21st Street, Anacortes, WA 98221 | 2012-05-31 |
| 1881954279 | Lindsay Anne Newlon | Family Medicine | 2511 M Ave Ste B, Anacortes, WA 98221 | 2012-05-21 |
| Find all providers in zip 98221 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811504277 | Inland Northwest Renal Care Group, LLC | Clinic/Center | 2405 West Washinton Ave, Yakima, WA 98903 | 2020-09-29 |
| 1447867247 | Inland Northwest Renal Care Group, LLC | Clinic/Center | 200 Westerly Rd Ste 104, Bellingham, WA 98226-6489 | 2020-09-25 |
| 1720690506 | Total Renal Care Inc | Clinic/Center | 16290 Auto Ln, Sumner, WA 98390-2568 | 2020-08-21 |
| 1801404124 | Northwest Kidney Centers | Clinic/Center | 1010 Se Everett Mall Way Ste 104, Everett, WA 98208-2855 | 2020-07-22 |
| 1134768088 | Renal Care Group Northwest, Inc. | Clinic/Center | 19663 Sr 410 E, Bonney Lake, WA 98391-5202 | 2019-12-24 |
| 1932757093 | Northwest Kidney Centers | Clinic/Center | 4401 S Trenton St, Seattle, WA 98118-4923 | 2019-08-30 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1861981177 | Northwest Kidney Centers | Clinic/Center | 501 S 336th St Ste 110, Federal Way, WA 98003-6745 | 2018-05-02 |
| 1063901379 | Northwest Kidney Centers | Clinic/Center | 6021 12th St E Ste 100, Fife, WA 98424-1399 | 2018-05-02 |
| 1255838694 | Franciscan Health System | Clinic/Center | 19420 State Route 410 E, Bonney Lake, WA 98391-8472 | 2018-04-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PUGET SOUND KIDNEY CENTERS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.