Healthcare Provider Details

I. General information

NPI: 1427321405
Provider Name (Legal Business Name): VASCULAR & SURGICAL CARE NORTHWEST, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 BOREN AVE STE 712
SEATTLE WA
98104-3301
US

IV. Provider business mailing address

PO BOX 22152
SEATTLE WA
98122-0152
US

V. Phone/Fax

Practice location:
  • Phone: 206-420-3119
  • Fax: 206-453-5912
Mailing address:
  • Phone: 206-420-3119
  • Fax: 206-453-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License NumberMD00043254
License Number StateWA

VIII. Authorized Official

Name: JENIFER ROSE ARENDS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 206-420-3119