EASTSIDE PATHOLOGY INC PS (NPI# 1609830900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609830900 |
| Entity Type | Organization |
| Organization Name | EASTSIDE PATHOLOGY INC PS |
| Practice Address |
1035 116th Ave Ne Bellevue WA 98004-4604 |
| Mailing Address |
Po Box 100559 Florence SC 29501-0559 |
| Practice Telephone | 4256885000 |
| Practice Fax Number | 4256885959 |
| Mailing Telephone | 8436644300 |
| Mailing Fax Number | 8436644308 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2008-06-06 |
| Authorized Official Name | DR. BRENT DAVID BENJAMIN (PRESIDENT) |
| Authorized Official Telephone | 4252515168 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
MD00032601 | WA | Allopathic & Osteopathic Physicians |
| N | 207ZD0900X |
Pathology Specialization: Dermatopathology |
MD00032601 | WA | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
MD00041011 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7045651 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013184621 | Eastside Pathology Inc Ps | Pathology | 1280 116th Ave Ne, Suite 100, Bellevue, WA 98004-3803 | 2008-05-13 |
| Street Address |
1035 116TH AVE NE |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-4604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609843382 | Karen Knops | Internal Medicine | 1035 116th Ave Ne, Bellevue, WA 98004-4604 | 2006-03-02 |
| 1699389494 | Mary Katherine O'sullivan | Registered Nurse | 1035 116th Ave Ne, Bellevue, WA 98004-4604 | 2020-08-31 |
| 1942813878 | Alyssa Nguyen | Registered Nurse | 1035 116th Ave Ne, Bellevue, WA 98004-4687 | 2020-08-29 |
| 1811511603 | Magen Alicia Hamil | Registered Nurse | 1035 116th Ave Ne, Bellevue, WA 98004-4604 | 2020-06-08 |
| 1053935007 | Linda Iraola | Nurse Practitioner | 1035 116th Ave Ne, Bellevue, WA 98004-4604 | 2020-06-05 |
| 1417583386 | Cody Jolene Espinoza | Registered Nurse | 1035 116th Ave Ne, Bellevue, WA 98004-4687 | 2020-03-22 |
| 1255967477 | Taylor Kae Young | Registered Nurse | 1035 116th Ave Ne, Bellevue, WA 98004-4604 | 2020-03-19 |
| 1285267070 | Penelope Tait | Registered Nurse | 1035 116th Ave Ne, Bellevue, WA 98004-4604 | 2020-02-19 |
| 1295372373 | Adaugo Iwuoha | Registered Nurse | 1035 116th Ave Ne, Bellevue, WA 98004 | 2019-12-07 |
| 1528520855 | Caresse Wicheta | Registered Nurse | 1035 116th Ave Ne, Bellevue, WA 98004-4604 | 2019-04-04 |
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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 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295001436 | Robert Farrell Kapela | Pathology | 5652 132nd Ave Ne, Bellevue, WA 98005-1033 | 2012-03-30 |
| 1417005802 | Novae Bernadette Simper | Pathology | Incyte Diagnostics, 1280 116th Ave. Ne, Bellevue, WA 98004 | 2007-01-08 |
| 1790750594 | Ira Steven Allen | Pathology | 1280 116th Ave Ne, Suite 210, Bellevue, WA 98004-3803 | 2006-02-23 |
| 1205242641 | Bayless Pathmark Inc | Pathology | 1400 W Main St, Bellevue, OH 44811-9088 | 2014-07-07 |
| 1942394531 | Zirrm Pathology, Inc. | Pathology | 1400 W Main St, Bellevue, OH 44811 | 2006-10-03 |
| 1982668364 | Lennart Cu Tan | Pathology | 1280 116th Ave Ne, Suite 210, Bellevue, WA 98004-3803 | 2006-04-13 |
| 1568426955 | Lisa Veva Thomassen | Pathology | 1280 116th Ave Ne, Suite 210, Bellevue, WA 98004-3803 | 2006-04-13 |
| 1255300703 | Melanie Grillis | Pathology | 1400 W Main St, Bellevue, OH 44811-9429 | 2006-03-16 |
| 1003883455 | David Denton Nordin | Pathology | 1280 116th Ave Ne, Ste. 210, Bellevue, WA 98004-3803 | 2006-03-03 |
| 1063489920 | Jon Dennis Conklin | Pathology | 1280 116th Ave Ne, Suite 210, Bellevue, WA 98004-3803 | 2006-03-01 |
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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.