Healthcare Provider Details

I. General information

NPI: 1588748123
Provider Name (Legal Business Name): PRECISION VEIN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 MERIDIAN AVE N SUITE 505
SEATTLE WA
98133-9008
US

IV. Provider business mailing address

10700 MERIDIAN AVE N SUITE 505
SEATTLE WA
98133-9008
US

V. Phone/Fax

Practice location:
  • Phone: 206-365-4100
  • Fax: 206-368-6898
Mailing address:
  • Phone: 206-365-4100
  • Fax: 206-368-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateWA

VIII. Authorized Official

Name: DR. JOHN EPHRON
Title or Position: PRESIDENT & OWNER
Credential: MD
Phone: 206-365-4100