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General NPI Number Information
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NPI Number | 1588378533
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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 | 01/12/2023
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 10821 SE 204TH ST
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City | KENT
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State | WA
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Zip | 98031-5570
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Country | US
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Telephone | 206-292-2771
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Fax |
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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 | CHIEF FINANCIAL OFFICER
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Name | JENNIFER ESLAVA
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Credential |
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Telephone | 206-292-2771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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