PACIFIC VASCULAR INCORPORATED (NPI# 1487709622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487709622 |
| Entity Type | Organization |
| Organization Name | PACIFIC VASCULAR INCORPORATED |
| Other Organization Name | PACIFIC VASCULAR- NORTHWEST |
| Practice Address |
1550 N 115th St D Wing Imaging Dept Seattle WA 98133-8401 |
| Mailing Address |
11714 N Creek Pkwy N Suite 100 Bothell WA 98011-8250 |
| Practice Telephone | 2063681638 |
| Practice Fax Number | 2063681635 |
| Mailing Telephone | 4254868868 |
| Mailing Fax Number | 4254868976 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2015-05-07 |
| Authorized Official Name | PAUL E OLMSTED (CEO/CFO) |
| Authorized Official Telephone | 4253987769 |
| 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 | 7015852 | 05 | |
| WA | RAILROAD MEDICARE | P00217284 | 01 |
| Other Name | Type Code |
|---|---|
| Pacific Vascular- Northwest | 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 |
1550 N 115TH ST D WING IMAGING DEPT |
| City | SEATTLE |
| State | WA |
| Zip Code | 98133-8401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588660831 | Eduardo Saul Margo | Internal Medicine | 1550 N 115th St, Seattle, WA 98133-8401 | 2005-06-22 |
| 1639784838 | Solee Lim | Registered Nurse | 1550 N 115th St, Seattle, WA 98133-8401 | 2020-09-14 |
| 1033745500 | Hanna Esther Kott | Nurse Practitioner | 1550 N 115th St, Seattle, WA 98133-8401 | 2020-03-17 |
| 1902431505 | Laura Janae Brazer | Nurse Practitioner | 1550 N 115th St, Seattle, WA 98133-8401 | 2020-03-04 |
| 1336771864 | Catherine Anne Bardsley | Nurse Practitioner | 1550 N 115th St, Seattle, WA 98133-8401 | 2020-02-12 |
| 1164073383 | Cher Ann Kier | Social Worker | 1550 N 115th St, Seattle, WA 98133-8401 | 2019-09-28 |
| 1023570637 | Brandee Wellman | Physical Therapy Assistant | 1550 N 115th St, Seattle, WA 98133-8401 | 2019-04-02 |
| 1780160846 | Trang T Nguyen | Nurse Anesthetist, Certified Registered | 1550 N 115th St, Seattle, WA 98133-8401 | 2018-07-12 |
| 1497253207 | Linda Joan Hagemeyer | Occupational Therapist | 1550 N 115th St, Seattle, WA 98133-8401 | 2018-01-26 |
| 1306351937 | Heather Louise Martin | Occupational Therapist | 1550 N 115th St, Seattle, WA 98133-8401 | 2017-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339388 | Marni Lynn Hanig | Occupational Therapist | 1900 N 170th St., Shoreline, WA 98133 | 2019-10-29 |
| 1871074807 | Minju Kim | Counselor | 14332 Burke Ave N, Seattle, WA 98133 | 2018-08-27 |
| 1821582941 | Hana Alema Misgina | Registered Nurse | 927 N 199th St, Shoreline, WA 98133 | 2018-06-21 |
| 1588177729 | Julie Benefiel | Pharmacist | 1536 N 115th St. Suite 100, Seattle, WA 98133 | 2017-11-09 |
| 1730607953 | Aurora Oaks, LLC | Skilled Nursing Facility | 16357 Aurora Avenue North, Shoreline, WA 98133 | 2017-09-08 |
| 1750801072 | Zoe Ana Cavnar-lewandowski | Counselor | 10700 Meridian Avenue N, Suite G-11, Seattle, WA 98133 | 2017-06-27 |
| 1851820211 | Adam Lee Gardner Sr. | Acupuncturist | 925 N 163rd Street, Unit B, Shoreline, WA 98133 | 2017-06-08 |
| 1376085209 | Pamela Ashby | Counselor | 2111 N. Northgateway, 212, Seattle, WA 98133 | 2016-11-09 |
| 1225584956 | General Dentistry | Dentist | 20109 Aurora Ave N, Ste D, Shoreline, WA 98133 | 2016-09-01 |
| 1144672668 | Aaron Neubauer | Behavioral Analyst | 13407 Greenwood Ave N, 216c, Seattle, WA 98133 | 2016-07-08 |
| Find all providers in zip 98133 | ||||
| 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 |
| 1447306444 | Pacific Vascular Incorporated | Physiological Laboratory | 4700 42nd Ave Sw, Suite 488, Seattle, WA 98116-4591 | 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.