PACIFIC NORTHWEST RENAL SERVICES LLC (NPI# 1790897692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790897692 |
| Entity Type | Organization |
| Organization Name | PACIFIC NORTHWEST RENAL SERVICES LLC |
| Practice Address |
312 Se Stone Mill Dr Suite 150 Vancouver WA 98684-3545 |
| Practice Telephone | 3602542323 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-12-06 |
| Authorized Official Name | MARK FAWCETT (SVP / TREASURER) |
| Authorized Official Telephone | 7814029000 |
| Is Organization Subpart | Y |
| Parent Organization Name | FRESENIUS MEDICAL CARE HOLDINGS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | PTAN | 50-2522 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689017790 | Pacific Northwest Renal Services LLC | Clinic/Center | 37139 Highway 26, Sandy, OR 97055-7271 | 2013-04-09 |
| Street Address |
312 SE STONE MILL DR SUITE 150 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-3545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285291849 | Pacifica Sylvan Park LLC | Alzheimer Center (Dementia Center) | 2400 Ne 112th Avenue, Vancouver, WA 98684 | 2019-05-20 |
| 1699242826 | Heidi Ericka Jackson | Registered Nurse | 15606 Ne 12th Way, Vancouver, WA 98684 | 2018-10-25 |
| 1477076727 | Brian Benasa Bardeloza | Dentist | 605 Se 164th Ave Ste 103, Vancouver, WA 98684 | 2017-07-19 |
| 1992226062 | Judith Moreno-castro | Massage Therapist | 2501 Ne 138th Ave., #60, Vancouver, WA 98684 | 2017-06-29 |
| 1346790706 | Samuel Joonsang Lee | Registered Nurse | 501 Se 172nd Ave Ste 210, Vancouver, WA 98684 | 2016-10-10 |
| 1912353178 | Cheryl A. Hamilton-jefferson | Counselor | 11818 Se Mill Plain Blvd Ste 311g, Vancouver, WA 98684 | 2016-05-06 |
| 1063866424 | Kim Forgione | Optometrist | 1900 Ne 162nd Ave Ste D103, Vancouver, WA 98684 | 2016-04-21 |
| 1700254257 | Desiree Haggart | Registered Nurse | 406 Se 131st St., Suite A101, Vancouver, WA 98684 | 2015-09-14 |
| 1215318068 | Paige M. King | Behavioral Analyst | 11818 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684 | 2015-06-17 |
| 1417354366 | Amanda Hilkey, Lmp | Massage Therapist | 108 Se 24th Ave, Ste 9, Vancouver, WA 98684 | 2014-11-20 |
| Find all providers in zip 98684 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154423317 | Pacific Northwest Renal Services, L.L.C. | Clinic/Center | 9105a Ne Hwy. 99, Ste. 102, Vancouver, WA 98665 | 2006-09-01 |
| 1467470369 | Total Renal Care Inc | Clinic/Center | 9120 Ne Vancouver Mall Dr, Vancouver, WA 98662-9401 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811504277 | Inland Northwest Renal Care Group, LLC | Clinic/Center | 2405 West Washinton Ave, Yakima, WA 98903 | 2020-09-29 |
| 1447867247 | Inland Northwest Renal Care Group, LLC | Clinic/Center | 200 Westerly Rd Ste 104, Bellingham, WA 98226-6489 | 2020-09-25 |
| 1720690506 | Total Renal Care Inc | Clinic/Center | 16290 Auto Ln, Sumner, WA 98390-2568 | 2020-08-21 |
| 1801404124 | Northwest Kidney Centers | Clinic/Center | 1010 Se Everett Mall Way Ste 104, Everett, WA 98208-2855 | 2020-07-22 |
| 1134768088 | Renal Care Group Northwest, Inc. | Clinic/Center | 19663 Sr 410 E, Bonney Lake, WA 98391-5202 | 2019-12-24 |
| 1932757093 | Northwest Kidney Centers | Clinic/Center | 4401 S Trenton St, Seattle, WA 98118-4923 | 2019-08-30 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1861981177 | Northwest Kidney Centers | Clinic/Center | 501 S 336th St Ste 110, Federal Way, WA 98003-6745 | 2018-05-02 |
| 1063901379 | Northwest Kidney Centers | Clinic/Center | 6021 12th St E Ste 100, Fife, WA 98424-1399 | 2018-05-02 |
| 1255838694 | Franciscan Health System | Clinic/Center | 19420 State Route 410 E, Bonney Lake, WA 98391-8472 | 2018-04-11 |
| 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.