EASTSIDE FERTILITY LAB INC (NPI# 1689731945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689731945 |
| Entity Type | Organization |
| Organization Name | EASTSIDE FERTILITY LAB INC |
| Practice Address |
1370 116th Ave Ne Ste 202 Bellevue WA 98004 |
| Mailing Address |
1370 116th Ave Ne Ste 100 Bellevue WA 98004 |
| Practice Telephone | 4254548018 |
| Practice Fax Number | 4256350742 |
| Mailing Telephone | 4254626100 |
| Mailing Fax Number | 4256350742 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES I KUSTIN (OWNER) |
| Authorized Official Telephone | 4256887740 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | MTS-1269 | WA | Laboratories |
| Street Address |
1370 116TH AVE NE STE 202 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255337853 | Lorne D. Trimble | Dentist | 1370 116th Ave Ne, Ste 101, Bellevue, WA 98004-3825 | 2005-06-28 |
| 1811438161 | Kimberley Napolitan | Dental Hygienist | 1370 116th Ave Ne, Suite 101, Bellevue, WA 98004-3825 | 2017-03-19 |
| 1043601719 | Melody C. Libatique | Chiropractor | 1370 116th Ave Ne, Bellevue, WA 98004-3825 | 2015-02-16 |
| 1669862165 | Yoko Miller | Audiologist | 1370 116th Ave Ne, Suite 201, Bellevue, WA 98004-3825 | 2015-02-04 |
| 1003242538 | Kristin Tessier | Massage Therapist | 1370 116th Ave Ne, Ste 206, Bellevue, WA 98004-3825 | 2013-09-16 |
| 1871844225 | Hiroka Mamiya | Audiologist | 1370 116th Ave Ne, Suite 201, Bellevue, WA 98004-3825 | 2012-09-25 |
| 1376892778 | Maan Salloum Md Pllc | Anesthesiology | 1370 116th Ave Ne, Suite 100, Bellevue, WA 98004 | 2012-08-31 |
| 1679856926 | Kristin Kimberly Denkinger | Massage Therapist | 1370 116th Ave Ne, 206, Bellevue, WA 98004-3825 | 2011-09-22 |
| 1528349016 | Samy Salama Md Inc Ps | Anesthesiology | 1370 116th Ave Ne, Suite 209, Bellevue, WA 98004-3825 | 2011-08-29 |
| 1376839951 | Lin Li | Internal Medicine | 1370 116th Ave Ne, Suite 209, Bellevue, WA 98004-3825 | 2011-06-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417263591 | Statewide Medicalequipment, Inc | Clinical Medical Laboratory | 7511 S 36th St, Ste 6, Bellevue, NE 68147-1244 | 2010-08-26 |
| 1497082879 | Pathology Associates Medical Laboratories, LLC | Clinical Medical Laboratory | 1000 124th Ave Ne Ste 101, Bellevue, WA 98005-2502 | 2009-11-05 |
| 1285677484 | Laboratory Corporation of America | Clinical Medical Laboratory | 3080 148th Avenue Se #115, Bellevue, WA 98007 | 2006-06-14 |
| 1740260421 | Health Ventures of Southern Illonois LLC | Clinical Medical Laboratory | 4000 N Illinois, Tri-lab LLC @ St Elizabeth's Medical Arts Build, Bellevue, IL 62226-1998 | 2006-01-19 |
| 1205813177 | Dynacare Northwest, Inc | Clinical Medical Laboratory | 12917 Se 38th St, Suite 100, Bellevue, WA 98006-1349 | 2005-12-30 |
| 1871589721 | Statewide Medical Equipment, Inc | Clinical Medical Laboratory | 7511 South 36 Street, Suites 6 & 7, Bellevue, NE 68147-1244 | 2005-09-26 |
| 1538662663 | Ideal Option, Pllc | Clinical Medical Laboratory | 1215 120th Ave Ne Ste 201, Bellevue, WA 98005-2135 | 2018-03-15 |
| 1720441801 | Laboratory Corporation of America | Clinical Medical Laboratory | 12917 Se 38th St, Suite 100, Bellevue, WA 98006-1349 | 2016-04-05 |
| 1407231483 | Altius Diagnostics Laboratory LLC | Clinical Medical Laboratory | 12100 Northup Way, Suite A, Bellevue, WA 98005-1920 | 2015-07-20 |
| 1174942957 | Ascendant Laboratories LLC | Clinical Medical Laboratory | 2800 Northup Way Ste 100, Bellevue, WA 98004-1440 | 2014-04-09 |
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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.