PACIFIC VASCULAR INCORPORATED (NPI# 1619300308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619300308 |
| Entity Type | Organization |
| Organization Name | PACIFIC VASCULAR INCORPORATED |
| Other Organization Name | PACIFIC VASCULAR-MOBILE 1 ULTRASOUND SERVICES |
| Practice Address |
11714 N Creek Pkwy N Ste 100 Bothell WA 98011-8250 |
| Mailing Address |
11714 N Creek Pkwy N Suite 100 Bothell WA 98011-8250 |
| Practice Telephone | 4254868868 |
| Practice Fax Number | 4254868976 |
| Mailing Telephone | 4254868868 |
| Mailing Fax Number | 4254868976 |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2019-12-10 |
| Authorized Official Name | PAUL E OLMSTED (CFO) |
| Authorized Official Telephone | 4253987769 |
| Is Organization Subpart | Y |
| Parent Organization Name | PACIFIC VASCULAR INCORPORATED |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | WA | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7015852 | 05 |
| Other Name | Type Code |
|---|---|
| Pacific Vascular-Mobile 1 Ultrasound Services | Other Name - Individual/Organization |
| Pacific Vascular-Mobile 1 Ultrasound Srvs-Yakima | Doing Business As Name - 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 |
| 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 |
| 1750436945 | Pacific Vascular Incorporated | Physiological Laboratory | 11714 N Creek Pkwy N, Suite 100, Bothell, WA 98011-8250 | 2007-01-25 |
| Street Address |
11714 N CREEK PKWY N STE 100 |
| City | BOTHELL |
| State | WA |
| Zip Code | 98011-8250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619316189 | James W Brown | Radiologic Technologist | 11714 N Creek Pkwy N Ste 100, Bothell, WA 98011-8250 | 2013-06-18 |
| 1033550579 | Ajay Zachariah | Spec/Tech, Cardiovascular | 11714 N Creek Pkwy N Ste 100, Bothell, WA 98011-8250 | 2013-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831714476 | Giovanna Dominique Seibel | Behavior Technician | 19204 North Creek Parkway, Building 2 Ste 110, Bothell, WA 98011 | 2020-06-09 |
| 1366070880 | Cristian Josue Rivera Nales | Behavioral Analyst | 19204 North Creek Pkwy Building 2, Suite 110, Bothell, WA 98011 | 2020-03-30 |
| 1205466968 | Ashley Lynn Lockwood O'neil | Counselor | 9201 120th Ave Ne, #108, Bothell, WA 98011 | 2020-01-22 |
| 1508415290 | Alexis Catalina Bailey | Behavior Technician | 19204 North Creek Pkwy, Building 2, Suite 110, Bothell, WA 98011 | 2019-09-05 |
| 1790337194 | Nw Foot and Ankle Specialists, LLC | Podiatrist | 12900 Ne 180th St, Ste 150, Bothell, WA 98011 | 2019-07-15 |
| 1154849784 | Andrea Reynolds | Counselor | 10516 East Riverside Drive, Bothell, WA 98011 | 2017-09-04 |
| 1912353111 | Pediatric Associates, Inc., Dba Allegro Pediatrics | Pediatrics | 11724 Ne 195th Street, Suite #100, Bothell, WA 98011 | 2016-05-06 |
| 1699145508 | Kelsie Ann Mcgladrey | Physical Therapist | 18504 Bethell Way Ne, Bethell, WA 98011 | 2015-10-05 |
| 1205217882 | Isaac-gregory Hyde Robancho | Massage Therapist | 10024 Main Street, Suite 2 C, Bothell, WA 98011 | 2015-06-09 |
| 1962889154 | Jennifer Zhang Colbert | Dentist | 19115 112th Ave Ne., Suite 6101, Bothell, WA 98011 | 2015-04-27 |
| Find all providers in zip 98011 | ||||
| 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 |
|---|---|---|---|---|
| 1700329828 | Braincare, LLC | Physiological Laboratory | 19909 120th Ave Ne Ste 203, Bothell, WA 98011-8242 | 2016-11-21 |
| 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 |
| 1750436945 | Pacific Vascular Incorporated | Physiological Laboratory | 11714 N Creek Pkwy N, Suite 100, Bothell, WA 98011-8250 | 2007-01-25 |
| 1295881217 | Pacific Vascular Incorporated | Physiological Laboratory | 11714 N Creek Pkwy N, Suite 100, Bothell, WA 98011-8250 | 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 |
| 1952777427 | Ronald Berenson | Physiological Laboratory | 2032 41st Avenue, Seattle, WA 98112 | 2015-08-19 |
| 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 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.