DIAGNOSTIC VASCULAR LABORATORY, LLC (NPI# 1023154465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023154465 |
| Entity Type | Organization |
| Organization Name | DIAGNOSTIC VASCULAR LABORATORY, LLC |
| Practice Address |
3911 Castlevale Rd Suite 105 Yakima WA 98902-7807 |
| Practice Telephone | 5095757652 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2010-07-20 |
| Authorized Official Name | MRS. SUSAN YOUNGSTROM (MGR) |
| Authorized Official Telephone | 5095757652 |
| 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 | 7017049 | 05 |
| Street Address |
3911 CASTLEVALE RD SUITE 105 |
| City | YAKIMA |
| State | WA |
| Zip Code | 98902-7807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164468062 | Judith A Hargis | Obstetrics & Gynecology | 3911 Castlevale Rd, Suite 301, Yakima, WA 98902-7807 | 2006-06-21 |
| 1013154038 | Michael Severin Shultis | Physician Assistant | 3911 Castlevale Rd, Suite 301, Yakima, WA 98902-7807 | 2009-01-13 |
| 1841458783 | Goldy Bansal | Internal Medicine | 3911 Castlevale Rd, Suite 201, Yakima, WA 98902-7807 | 2008-05-28 |
| 1063540094 | Cascade Womens Healthcare | Obstetrics & Gynecology | 3911 Castlevale Rd, Suite 301, Yakima, WA 98902-7807 | 2007-03-01 |
| 1083757967 | Kari A Brewer | Physician Assistant | 3911 Castlevale Rd, Suite 201, Yakima, WA 98902-7807 | 2007-02-14 |
| 1992879860 | Anna Marie Fulton | Obstetrics & Gynecology | 3911 Castlevale Rd, Suite 301, Yakima, WA 98902-7807 | 2006-11-20 |
| 1780772434 | Carl Youngstrom | Surgery | 3911 Castlevale Rd, Suite 105, Yakima, WA 98902-7807 | 2006-10-10 |
| 1710089636 | Insight Diagnostic Imaging Pa | Internal Medicine | 3911 Castlevale Rd, Suite 305, Yakima, WA 98902-7807 | 2006-09-01 |
| 1154432904 | Kirk Torgle Ecklund | Dermatology | 3911 Castlevale Rd, Ste 301, Yakima, WA 98902-7807 | 2006-08-31 |
| 1891708574 | Idolina Maltos | Family Medicine | 3911 Castlevale Rd, Yakima, WA 98902-7807 | 2006-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653203 | Laboratory Corporation of America | Clinical Medical Laboratory | 314 S 11th Ave Suite A, Yakima, WA 98902 | 2019-08-05 |
| 1669967865 | Rebecca Schrader | Speech-Language Pathologist | Children's Village 3801 Kern Road, Yakima, WA 98902 | 2018-06-29 |
| 1720572928 | Hyperbaric Centers of Washington | Preventive Medicine | 302 S. 12th Ave., Yakima, WA 98902 | 2018-06-20 |
| 1487155503 | Courtney Lombardi | Nurse Practitioner | 1515 W Yakima Ave, Yakima, WA 98902 | 2018-02-23 |
| 1003329665 | Maria-elena Mendoza | Case Manager/Care Coordinator | 918 E Mead Avenue, Yakima, WA 98902 | 2017-11-06 |
| 1679017610 | Claudia Zepeda | Massage Therapist | 3908 Creekside Loop Ste # 110, Yakima, WA 98902 | 2016-12-09 |
| 1093194425 | Silas Klaver | Podiatrist | 1607 Creekside Loop Ste 140, Yakima, WA 98902 | 2015-05-18 |
| 1821490905 | Jen Lynn Silver | Massage Therapist | 3512 Tieton Dr, Yakima, WA 98902 | 2014-09-20 |
| 1194131383 | Brenna Claire Hayes | Genetic Counselor, MS | 2903 W Walnut, Yakima, WA 98902 | 2014-07-08 |
| 1720400435 | Agnes Nadine Jeske | Speech-Language Pathologist | 621 S. 13th Ave., Mckinley Elementary School, Yakima, WA 98902 | 2014-01-15 |
| Find all providers in zip 98902 | ||||
| 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 |
|---|---|---|---|---|
| 1750615696 | Pacific Vascular Incorporated | Physiological Laboratory | 3999 Englewood Ave, Suite 203, Yakima, WA 98902-6334 | 2009-09-24 |
| 1831245836 | Pacific Vascular Incorporated | Physiological Laboratory | 3902 Creekside Loop, Suite 105, Yakima, WA 98902-4876 | 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 |
| 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 |
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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.