Organization
DIAGNOSTIC VASCULAR LABORATORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN YOUNGSTROM (MGR)
(509) 575-7652
Entity
Organization
Contact information
Practice address
3911 CASTLEVALE RD, SUITE 105, YAKIMA, WA 98902-7807
(509) 575-7652
Mailing address
3911 CASTLEVALE RD, SUITE 105, YAKIMA, WA 98902-7807
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7017049
—
WA
Enumeration date
01/30/2007
Last updated
07/20/2010
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