Organization Name: | PACIFIC VASCULAR INCORPORATED |
NPI Number: | 1831245836 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL E OLMSTED (CEO/CFO) |
Mailing Address: | 4702 Summitview Ave Suite 102 Yakima |
State: | WA US |
Postal Code: | 989086001 |
Phone Number: | 5092495735 |
Fax Number: | 5092495734 |
NPI Enumeration Date: | 01/25/2007 |
NPI Last Update Date: | 05/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 293D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Laboratories |
Taxonomy Classification: | Physiological Laboratory |
Taxonomy Specialization: | |
Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |