Healthcare Provider Details

I. General information

NPI: 1427255975
Provider Name (Legal Business Name): NORTHWEST SOMNOLOGISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E JEFFERSON ST SECOND FLOOR
SEATTLE WA
98122-5698
US

IV. Provider business mailing address

PO BOX 22796
SEATTLE WA
98122-0796
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-2020
  • Fax: 206-299-3812
Mailing address:
  • Phone: 206-484-8777
  • Fax: 206-299-3812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateWA

VIII. Authorized Official

Name: DR. RALPH A PASCUALY
Title or Position: DIRECTOR
Credential: M.D.
Phone: 206-484-8777