Healthcare Provider Details

I. General information

NPI: 1356310866
Provider Name (Legal Business Name): CELLNETIX PATHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 12/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 COLBY AVENUE
EVERETT WA
98206
US

IV. Provider business mailing address

PO BOX 3941
SEATTLE WA
98124-3941
US

V. Phone/Fax

Practice location:
  • Phone: 425-259-5141
  • Fax: 425-339-9184
Mailing address:
  • Phone: 206-386-2676
  • Fax: 206-386-2709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code207ZM0300X
TaxonomyMedical Microbiology Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD RAYMOND HOWARD
Title or Position: CHIEF OPERATING OFFICER
Credential: MD PHD
Phone: 206-386-2676