Organization
PUGET SOUND KIDNEY CENTERS
Active
Organization
PUGET SOUND KIDNEY CENTERS
Active
Other names
PSKC Anacortes
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD S KELLY (PRESIDENT AND CEO)
(425) 259-5195
Entity
Organization
Contact information
Practice address
809 31ST ST, ANACORTES, WA 98221
(360) 755-3586
(360) 982-2693
Mailing address
1019 PACIFIC AVE, EVERETT, WA 98201-4148
(425) 259-5195
(425) 259-4860
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
600401431
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2036232
—
WA
01
—
50-2573
MEDICARE ID-TYPE UNSPECIFIED
WA
Enumeration date
03/14/2014
Last updated
02/04/2015
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