Healthcare Provider Details

I. General information

NPI: 1598501041
Provider Name (Legal Business Name): SALISH PEDIATRIC CARDIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20218 77TH AVE NE STE B
ARLINGTON WA
98223-4602
US

IV. Provider business mailing address

20218 77TH AVE NE STE B
ARLINGTON WA
98223-4602
US

V. Phone/Fax

Practice location:
  • Phone: 360-526-0097
  • Fax:
Mailing address:
  • Phone: 360-526-0097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA DAVID WELDIN
Title or Position: CEO
Credential: MD
Phone: 206-947-6997