MEDICARE: PRECISION VEIN CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician		WA

General Provider Information

NPI Number	:	1588748123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION VEIN CENTER

Provider Business Mailing Address
First Line	:	10700 MERIDIAN AVE N
Second Line	:	SUITE 505
City	:	SEATTLE
State	:	WA
Zip	:	98133-9008
Country	:	US
Telephone Number	:	206-365-4100
Fax Number	:	206-368-6898

Provider Business Practice Location Address
First Line	:	10700 MERIDIAN AVE N
Second Line	:	SUITE 505
City	:	SEATTLE
State	:	WA
Zip	:	98133-9008
Country	:	US
Telephone Number	:	206-365-4100
Fax Number	:	206-368-6898

Authorized Official
Title or Position	:	PRESIDENT & OWNER
Name	:	DR. JOHN EPHRON
Credential	:	MD
Telephone Number	:	206-365-4100

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	08/22/2020

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Directions to “PRECISION VEIN CENTER ” Practice Location

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