PUGET SOUND KIDNEY CENTERS (NPI# 1093835811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093835811 |
| Entity Type | Organization |
| Organization Name | PUGET SOUND KIDNEY CENTERS |
| Other Organization Name | PSKC - SOUTH |
| Practice Address |
21309 44th Ave W Mountlake Terrace WA 98043-3507 |
| Mailing Address |
1005 Pacific Ave Everett WA 98201-4148 |
| Practice Telephone | 4257441095 |
| Practice Fax Number | 4257751144 |
| Mailing Telephone | 4252595195 |
| Mailing Fax Number | 4252594890 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2008-02-05 |
| Authorized Official Name | HAROLD S KELLY (PRESIDENT & 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 |
WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 3144805 | 05 |
| Other Name | Type Code |
|---|---|
| PSKC - SOUTH | 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 |
| 1073939062 | Puget Sound Kidney Centers | Clinic/Center | 809 31st St, Anacortes, WA 98221 | 2014-03-14 |
| 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 |
21309 44TH AVE W |
| City | MOUNTLAKE TERRACE |
| State | WA |
| Zip Code | 98043-3507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487289856 | Libby Shapiro Kimmett | Dietitian, Registered | 21309 44th Ave W, Mountlake Terrace, WA 98043 | 2020-03-06 |
| 1629519152 | Kathyh Harvey | Dietitian, Registered | 21309 44th Ave W, Mountlake Terrace, WA 98043-3507 | 2017-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785357 | Maria Angelica Lopez | Counselor | 22815 Lakeview Dr Apt 'g' - 308, Mountlake Terrace, WA 98043 | 2020-06-17 |
| 1447891411 | Juana Antonia Hartley | Technician | 4808 221st St. Sw, Mountlake Terrace, WA 98043 | 2019-10-01 |
| 1437709961 | Jamil Vaughn Shoot | Acupuncturist | 21705 56th Ave W, Mount Lake Terrace, WA 98043 | 2019-09-17 |
| 1942709449 | Julie A Hill | Registered Nurse | 22001 44th Ave W, Mountlake Terrace, WA 98043 | 2018-02-09 |
| 1205285004 | Preeti Suryakumar | Occupational Therapist | 23008 56th Ave West, Vineyard Park At Mountlake Terrace, Mountlake Terrace, WA 98043 | 2016-06-13 |
| 1467819623 | Liisa Marlene Geyer | Social Worker | 6021 244th St Sw # 400, Mountlake Terrace, WA 98043 | 2016-01-19 |
| 1346611696 | Isaiah Johnson | Massage Therapist | 21604 66th Ave N, #a, Mountlake Terrace, WA 98043 | 2015-10-13 |
| 1417343260 | Sunanta Angela Astorga | Counselor | 6021 244th St Sw #400, Mountlake Terrace, WA 98043 | 2015-04-08 |
| 1366835746 | Teresa Antoinette White | Chiropractor | 6603 220th St. Sw Suite 100, Mountlake Terrace, WA 98043 | 2015-03-10 |
| 1508156647 | Monica Jean Scott | Massage Therapist | 23009-56 Ave W # B, Mountlake Terrace, WA 98043 | 2011-04-11 |
| Find all providers in zip 98043 | ||||
| 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 | ||||
| City | MOUNTLAKE TERRACE |
| Zip Code | 98043 |
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.