PACIFIC VASCULAR INCORPORATED (NPI# 1639776842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639776842 |
| Entity Type | Organization |
| Organization Name | PACIFIC VASCULAR INCORPORATED |
| Other Organization Name | PACIFIC VASCULAR-PT ANGELES |
| Practice Address |
315 E 8th St Lowr Level Port Angeles WA 98362-6217 |
| Mailing Address |
11714 N Creek Pkwy N Ste 100 Bothell WA 98011-8099 |
| Practice Telephone | 3605043842 |
| Practice Fax Number | 3605043843 |
| Mailing Telephone | 4254868868 |
| Mailing Fax Number | 4254868976 |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-13 |
| Authorized Official Name | MRS. BONNIE M BROWN (CEO/TECHNICAL DIRECTOR) |
| Authorized Official Telephone | 4253987781 |
| Authorized Official Credential | RVT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7015852 | 05 |
| Other Name | Type Code |
|---|---|
| Pacific Vascular-Pt Angeles | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1750436945 | Pacific Vascular Incorporated | Physiological Laboratory | 11714 N Creek Pkwy N, Suite 100, Bothell, WA 98011-8250 | 2007-01-25 |
| Street Address |
315 E 8TH ST LOWR LEVEL |
| City | PORT ANGELES |
| State | WA |
| Zip Code | 98362-6217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831735778 | Jayme Marie Williams | Technician | 518 S. Liberty St., Port Angeles, WA 98362 | 2019-11-26 |
| 1780229559 | Barbara Amsler Nutrition, Pllc | Dietitian, Registered | 320 E. 5th St., Port Angeles, WA 98362 | 2019-11-15 |
| 1902315005 | Barbara Amsler | Nutritionist | 116 S. Ennis St, Port Angeles, WA 98362 | 2017-09-21 |
| 1134659667 | Janet Li Hanson | Registered Nurse | 532 South Alder Lane, Port Angeles, WA 98362 | 2017-06-18 |
| 1790220192 | Monica Kay Henry | Massage Therapist | 102 1/2 East 1st Street Suite #7, Port Angeles, WA 98362 | 2016-12-21 |
| 1124491725 | Gabrielle Carter | Naturopath | 1126 Columbia St, Port Angeles, WA 98362 | 2015-11-04 |
| 1912301185 | Danya Lyn Davis | Massage Therapist | 106 W. Lauridsen Blvd., Port Angeles, WA 98362 | 2014-10-17 |
| 1528470861 | Richard Dean Thorson | Orthopaedic Surgery | 719 S. Laurel St, Olympic Chiropractic, Port Angels, WA 98362 | 2014-05-21 |
| 1780001743 | Dr Adam Cramer Pllc | Clinic/Center | 104 W. 3rd St, Port Angeles, WA 98362 | 2014-03-27 |
| 1588089189 | Melanie Mccaughan | Counselor | 933 E First St, Port Angeles, WA 98362 | 2014-02-19 |
| Find all providers in zip 98362 | ||||
| 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 |
| 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 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | PORT ANGELES |
| Zip Code | 98362 |
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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.