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General NPI Number Information
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NPI Number | 1578507919
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Entity Type | Organization
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Legal Business Name | NORTHWEST KIDNEY CENTERS
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 12901 20TH AVE S
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City | SEATAC
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State | WA
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Zip | 98168-5159
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Country | US
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Telephone | 206-343-4870
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Fax | 206-343-4884
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Provider Business Mailing Address
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Address Line | 12901 20TH AVE S STE 100
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City | SEATAC
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State | WA
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Zip | 98168-5159
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Country | US
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Telephone | 206-292-2771
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Fax | 206-860-5821
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Authorized Official
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Title or Position | CFO
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Name | JENNIFER D. ESLAVA
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Credential |
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Telephone | 206-720-8506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | CF00003625
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 20609MS
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License Number State | ID
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