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General NPI Number Information
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NPI Number | 1043365257
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Entity Type | Organization
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Legal Business Name | PACIFIC VASCULAR INCORPORATED
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1 E MAIN ST SUITE 120
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City | AUBURN
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State | WA
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Zip | 98002-4905
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Country | US
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Telephone | 253-887-8673
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Fax | 425-486-8976
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Provider Business Mailing Address
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Address Line | 11714 N CREEK PKWY N STE 100
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City | BOTHELL
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State | WA
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Zip | 98011-8250
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Country | US
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Telephone | 425-486-8868
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Fax | 425-486-8976
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Authorized Official
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Title or Position | CEO/TECHNICAL DIRECTOR
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Name | BONNIE M BROWN
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Credential | RVT
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Telephone | 425-398-7781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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