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General NPI Number Information
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NPI Number | 1083210025
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Entity Type | Organization
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Legal Business Name | NEO PACIFIC CORP
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Dates
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Enumeration Date | 12/06/2020
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Last Update Date | 12/06/2020
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Provider Practice Location Address
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Address Line | 4636 E MARGINAL WAY S STE B250
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City | SEATTLE
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State | WA
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Zip | 98134-2376
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Country | US
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Telephone | 206-455-8970
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Fax |
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Provider Business Mailing Address
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Address Line | 22039 NE 74TH PL
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City | REDMOND
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State | WA
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Zip | 98053-7776
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Country | US
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Telephone | 425-301-1900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAYLOR COLLYER
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Credential |
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Telephone | 425-301-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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