Organization
PAKC-DSL INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DUFFY (GENERAL MANAGER)
(360) 447-5635
Entity
Organization
Contact information
Practice address
550 17TH AVE., STE. 300, SEATTLE, WA 98122
(360) 447-5630
(360) 447-5669
Mailing address
PO BOX 2171, BREMERTON, WA 98310
(360) 447-5630
(360) 447-5669
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021619
—
WA
Enumeration date
03/11/2013
Last updated
03/11/2013
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