PUGET SOUND KIDNEY CENTERS (NPI# 1295855013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295855013 |
Entity Type | Organization |
Organization Name | PUGET SOUND KIDNEY CENTERS |
Other Organization Name | PSKC - WHIDBEY ISLAND |
Practice Address |
430 Se Midway Blvd Oak Harbor WA 98277-5017 |
Mailing Address |
1005 Pacific Ave Everett WA 98201-4148 |
Practice Telephone | 3606796706 |
Practice Fax Number | 3606796957 |
Mailing Telephone | 4252595195 |
Mailing Fax Number | 4252594890 |
Enumeration Date | 2007-03-29 |
Last Update Date | 2008-02-05 |
Authorized Official Name | HAROLD S KELLY (PRESIDENT & CEO) |
Authorized Official Telephone | 4252595195 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
WA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | 3144805 | 05 |
Other Name | Type Code |
---|---|
PSKC - WHIDBEY ISLAND | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
1528478609 | Puget Sound Kidney Centers | Clinic/Center | 18121 149th Street Se, Monroe, WA 98272 | 2014-04-29 |
1073939062 | Puget Sound Kidney Centers | Clinic/Center | 809 31st St, Anacortes, WA 98221 | 2014-03-14 |
1093835811 | Puget Sound Kidney Centers | Clinic/Center | 21309 44th Ave W, Mountlake Terrace, WA 98043-3507 | 2007-03-29 |
1386764009 | Puget Sound Kidney Centers | Clinic/Center | 18828 Smokey Point Blvd, Arlington, WA 98223-8266 | 2007-03-29 |
1053357434 | Puget Sound Kidney Centers | Clinic/Center | 1005 Pacific Ave, Everett, WA 98201-4148 | 2006-06-22 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Washington State Corporations | PUGET SOUND KIDNEY CENTERS | 1019 Pacific Ave, Everett, WA 98201-4148 |
Street Address |
430 SE MIDWAY BLVD |
City | OAK HARBOR |
State | WA |
Zip Code | 98277-5017 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952951782 | Amber Dorothy Rettus | Counselor | 31640 Wa -20 #1, Oak Harbor, WA 98277 | 2019-09-13 |
1528612082 | Grace Alfery Finnell | Pharmacist | 31645 Sr 20, Oak Harbor, WA 98277 | 2019-08-01 |
1407321839 | Leah Marie Threats | Behavior Technician | Advance Behavioral Education Continuum, 231 Se Barrington Dr. Ste 201, Oak Harbor, WA 98277 | 2018-10-12 |
1285115329 | Jared M Wirth | Dentist | 275 Se Cabot Dr., #b201, Oak Harbor, WA 98277 | 2018-08-27 |
1952896854 | Makella Ann Mccormack | Behavior Technician | 231 Se Barrington Dr. Ste 203, Oak Harbor, WA 98277 | 2018-06-25 |
1972004703 | Sophia Kaye Johnson | Counselor | 3165 Wa-20 Suite#1, Oak Harbor, WA 98277 | 2018-02-27 |
1043728827 | Lance D Keyes Dds | Dentist | 32650 State Route 20 Ste E106, Oak Harbor, WA 98277 | 2018-01-16 |
1689195075 | Laboratory Corporation of America | Clinical Medical Laboratory | 275 Se Cabot Dr Ste A9, Oak Harbor, WA 98277 | 2017-07-06 |
1841723368 | Stephanie Bailey | Behavioral Analyst | 231 Barrington Dr. Suite 201, Oak Harbor, WA 98277 | 2017-04-11 |
1336684463 | Angel Lyn Faith Camello | Behavior Technician | 31955 State Route 20, #3, Oak Harbor, WA 98277 | 2016-12-28 |
Find all providers in zip 98277 |
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 |
---|---|---|---|---|
1831320753 | Total Renal Care Inc | Clinic/Center | 32650 State Road 20, Building D; Suite 101, Oak Harbor, WA 98277-2641 | 2009-07-28 |
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 |
City | OAK HARBOR |
Zip Code | 98277 |
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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.