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General NPI Number Information
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NPI Number | 1932383304
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Entity Type | Organization
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Legal Business Name | CITY SLEEP LAB LLC
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 95 S TOBIN ST STE 25
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City | RENTON
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State | WA
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Zip | 98057-5324
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Country | US
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Telephone | 206-228-1844
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Fax |
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Provider Business Mailing Address
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Address Line | 95 S TOBIN ST STE 205
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City | RENTON
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State | WA
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Zip | 98057-5324
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Country | US
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Telephone | 206-228-1844
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. JOEL M DURIAS
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Credential | RPSGT
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Telephone | 206-228-1844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | WA
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