Organization
KAN-DI-KI LLC
Active
Other names
Diagnostic Laboratories, TridentCare
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN C CUOMO (AUTHORIZED OFFICIAL/CFO)
(800) 786-8015
Entity
Organization
Contact information
Practice address
1134 INDUSTRY DR, TUKWILA, WA 98188-4803
(206) 466-1478
(410) 472-1754
Mailing address
215 SCHILLING CIR STE 114, HUNT VALLEY, MD 21031-1113
(800) 786-8015
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407151475
—
WA
01
—
P01005633
RAILROAD MEDICARE
WA
Enumeration date
01/21/2011
Last updated
03/11/2026
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