Healthcare Provider Details

I. General information

NPI: 1467512293
Provider Name (Legal Business Name): MEDICAL DIAGNOSTIC SPECIALTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 SMOKEY POINT DR SUITE J
ARLINGTON WA
98223-4711
US

IV. Provider business mailing address

3131 SMOKEY POINT DR SUITE J
ARLINGTON WA
98223-4711
US

V. Phone/Fax

Practice location:
  • Phone: 360-653-5960
  • Fax:
Mailing address:
  • Phone: 360-653-5960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DALE N THULINE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 360-653-5960