1851359509 NPI number — PULMONARY CONSULTANTS PLLC

Table of content: (NPI 1851359509)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851359509 NPI number — PULMONARY CONSULTANTS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PULMONARY CONSULTANTS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851359509
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1708 YAKIMA AVE
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98405-5307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-722-0430
Provider Business Mailing Address Fax Number:
253-272-0160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1708 YAKIMA AVE
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405-5307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-722-0430
Provider Business Practice Location Address Fax Number:
253-272-0160
Provider Enumeration Date:
05/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RAI
Authorized Official First Name:
NAVDEEP
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
253-572-5140

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7073216 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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