PACIFIC VASCULAR INCORPORATED (NPI# 1447306444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447306444 |
| Entity Type | Organization |
| Organization Name | PACIFIC VASCULAR INCORPORATED |
| Other Organization Name | WEST SEATTLE - PVI VASCULAR LABORATORY |
| Practice Address |
4700 42nd Ave Sw Suite 488 Seattle WA 98116-4591 |
| Mailing Address |
11714 N Creek Pkwy N Suite 100 Bothell WA 98011-8250 |
| Practice Telephone | 2069359106 |
| Practice Fax Number | 2069337369 |
| Mailing Telephone | 4254868868 |
| Mailing Fax Number | 4254868976 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2009-10-19 |
| Authorized Official Name | FRANKLIN W. WEST (DIRECTOR OF PROFESSIONAL SERVICES) |
| Authorized Official Telephone | 4253987774 |
| Authorized Official Credential | BSN RN RVT RVS C |
| Is Organization Subpart | Y |
| Parent Organization Name | PACIFIC VASCULAR INCORPORATED |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | RAILROAD MEDICARE | P00217284 | 01 |
| WA | 7015852 | 05 |
| Other Name | Type Code |
|---|---|
| West Seattle - PVI Vascular Laboratory | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639776842 | Pacific Vascular Incorporated | Physiological Laboratory | 315 E 8th St Lowr Level, Port Angeles, WA 98362-6217 | 2020-10-01 |
| 1891017992 | Pacific Vascular Incorporated | Physiological Laboratory | 536 N 5th Ave, Suite B, Sequim, WA 98382-3079 | 2010-02-17 |
| 1376904078 | Pacific Vascular Incorporated | Physiological Laboratory | 1 E Main St, Suite 120, Auburn, WA 98002-4905 | 2016-03-09 |
| 1295145894 | Pacific Vascular Incorporated | Physiological Laboratory | 3104 Squalicum Pkwy, Suite 102, Bellingham, WA 98225-1941 | 2014-05-05 |
| 1619300308 | Pacific Vascular Incorporated | Physiological Laboratory | 11714 N Creek Pkwy N Ste 100, Bothell, WA 98011-8250 | 2013-08-16 |
| 1952608531 | Pacific Vascular Incorporated | Physiological Laboratory | 7315 212th St Sw, Suite 201a, Edmonds, WA 98026-7610 | 2011-02-17 |
| 1750615696 | Pacific Vascular Incorporated | Physiological Laboratory | 3999 Englewood Ave, Suite 203, Yakima, WA 98902-6334 | 2009-09-24 |
| 1043365257 | Pacific Vascular Incorporated | Physiological Laboratory | 1 E Main St, Suite 120, Auburn, WA 98002-4905 | 2007-01-25 |
| 1154476216 | Pacific Vascular Incorporated | Physiological Laboratory | 1600 E Jefferson St, Suite 201, Seattle, WA 98122-5698 | 2007-01-25 |
| 1295880433 | Pacific Vascular Incorporated | Physiological Laboratory | 1229 Madison St, Suite 810, Seattle, WA 98104-3586 | 2007-01-25 |
| Street Address |
4700 42ND AVE SW SUITE 488 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98116-4591 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295755957 | Kari Dianne Chellis | Dentist | 4700 42nd Ave Sw, Suite # 555, Seattle, WA 98116-4583 | 2006-07-19 |
| 1225688740 | Rebecca Rachelle Lunde | Physical Therapist | 4700 42nd Ave Sw, Seattle, WA 98116-4591 | 2019-09-17 |
| 1851819635 | Nitya Narayanan | Dentist | 4700 42nd Ave Sw, Seattle, WA 98116-4591 | 2017-08-31 |
| 1023562907 | Christopher Wagner | Dentist | 4700 42nd Ave Sw, Suite 460, Seattle, WA 98116-4591 | 2016-08-09 |
| 1619357514 | Kari D Chellis Rdh Dds Ps | Dentist | 4700 42nd Ave Sw, Ste 555, Seattle, WA 98116-4591 | 2015-06-05 |
| 1588080261 | Valorie Johnson | Behavioral Analyst | 4700 42nd Ave Sw, Suite 552, Seattle, WA 98116-4591 | 2014-03-05 |
| 1407104649 | Nw Communication Connections | Speech-Language Pathologist | 4700 42nd Ave Sw, Ste 447, Seattle, WA 98116-4591 | 2012-08-20 |
| 1467717884 | Laura Verellen Jewett | Physical Therapist | 4700 42nd Ave Sw, #510, Seattle, WA 98116-4591 | 2012-07-11 |
| 1134379647 | Colin H Naughton | Counselor | 4700 42nd Ave Sw, Suite 480, Seattle, WA 98116-4591 | 2008-09-22 |
| 1528274396 | Sheila Welsh Lyon | Counselor | 4700 42nd Ave Sw, Suite 480, Seattle, WA 98116-4591 | 2007-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992229702 | Franciscan City Urgent Care Services, Ps | Clinic/Center | 3900 Sw Alaska St, Seattle, WA 98116 | 2017-08-02 |
| 1538692280 | Stacey Devenney | Counselor | 3026 52nd Ave Sw, Seattle, WA 98116 | 2017-04-10 |
| 1336698786 | Andrew Creed Gray | Physical Therapist | 3727 California Ave. Sw, Suite 1-a, Seattle, WA 98116 | 2016-09-27 |
| 1295281038 | Jenny Monfore | Mechanotherapist | 6633 Sw Admiral Way, Seattle, WA 98116 | 2016-08-31 |
| 1043666175 | Gretchen Gerhardt | Counselor | 3272 California Ave Sw Ste 300, Seattle, WA 98116 | 2016-05-07 |
| 1609274307 | Lekea Sharon Sarah Itero | Counselor | 1116 Summit Avenue Therapeutic Health Services, Seattle, WA 98116 | 2014-12-11 |
| 1306275284 | Elizabeth Davis | Dentist | 14212 Ambaum Blvd. Sw, Suite 100, Burien, WA 98116 | 2013-11-01 |
| 1689912859 | Seattle Pain and Wellness Institute | Clinic/Center | 4701 41st Ave., Sw, Suite 120, Seattle, WA 98116 | 2013-01-23 |
| 1851637953 | Chrissandra Ann Snider | Massage Therapist | 3258 California Ave Sw Ste D, Seattle, WA 98116 | 2012-12-17 |
| 1528302908 | Samara K Hoag | Registered Nurse | 3429 - 45th Ave Sw, Madison Middle School, Seattle, WA 98116 | 2012-11-26 |
| Find all providers in zip 98116 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952777427 | Ronald Berenson | Physiological Laboratory | 2032 41st Avenue, Seattle, WA 98112 | 2015-08-19 |
| 1154476216 | Pacific Vascular Incorporated | Physiological Laboratory | 1600 E Jefferson St, Suite 201, Seattle, WA 98122-5698 | 2007-01-25 |
| 1295880433 | Pacific Vascular Incorporated | Physiological Laboratory | 1229 Madison St, Suite 810, Seattle, WA 98104-3586 | 2007-01-25 |
| 1245385467 | Pacific Vascular Incorporated | Physiological Laboratory | 5300 Tallman Ave Nw, 2nd Floor Imaging, Seattle, WA 98107-3932 | 2007-01-25 |
| 1487709622 | Pacific Vascular Incorporated | Physiological Laboratory | 1550 N 115th St, D Wing Imaging Dept, Seattle, WA 98133-8401 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639776842 | Pacific Vascular Incorporated | Physiological Laboratory | 315 E 8th St Lowr Level, Port Angeles, WA 98362-6217 | 2020-10-01 |
| 1700329828 | Braincare, LLC | Physiological Laboratory | 19909 120th Ave Ne Ste 203, Bothell, WA 98011-8242 | 2016-11-21 |
| 1851715130 | Greater Sleep Solutions | Physiological Laboratory | 18801 Veterans Memorial Dr E Ste 1, Bonney Lake, WA 98391-5204 | 2014-02-07 |
| 1235432741 | Med-men LLC | Physiological Laboratory | 2522 N Proctor St, 468, Tacoma, WA 98406-5338 | 2010-12-06 |
| 1891017992 | Pacific Vascular Incorporated | Physiological Laboratory | 536 N 5th Ave, Suite B, Sequim, WA 98382-3079 | 2010-02-17 |
| 1780910091 | Agile Dx | Physiological Laboratory | 3413 56th St Nw, Suite C, Gig Harbor, WA 98335-8341 | 2009-10-21 |
| 1942441571 | Daniel Anyimah | Physiological Laboratory | 19604 Bing Road, Lynnwood, WA 98036 | 2009-03-11 |
| 1588600571 | Alpha Omega Sonography LLC | Physiological Laboratory | 12402 N Division St, Suite 205, Spokane, WA 99218-1930 | 2006-06-20 |
| 1053865220 | Pacific Vascular, Inc | Physiological Laboratory | 11714 N Creek Pkwy N, Suite 100, Bothell, WA 98011-8250 | 2016-08-05 |
| 1730534553 | Pacific Vascular, Inc | Physiological Laboratory | 11714 N Creek Pkwy N, Suite 100, Bothell, WA 98011-8250 | 2016-04-29 |
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| 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.