# PACIFIC SLEEP MEDICINE, A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134360217
- **Authorized official:** MS. NANCY M JOHNSON (CREDENTIALING)
- **Authorized official phone:** (909) 481-2577

## Contact information

- **Practice address:** 500 17TH AVE, SUITE A-20, SEATTLE, WA 98122-5711
- **Practice address phone:** (206) 386-4744
- **Practice address fax:** (206) 215-1135
- **Mailing address:** 10532 ACACIA ST, B-4, RANCHO CUCAMONGA, CA 91730-5446
- **Mailing address phone:** (909) 481-2577
- **Mailing address fax:** (909) 418-2546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/18/2009
- **Last updated:** 05/11/2009