Organization
NORTHWEST KIDNEY CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE F JACKSON (CEO)
(206) 292-2771
Entity
Organization
Contact information
Practice address
700 BROADWAY, SEATTLE, WA 98122
(206) 292-2771
(206) 292-2133
Mailing address
700 BROADWAY, SEATTLE, WA 98122
(206) 292-2771
(206) 292-2133
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6012975
—
WA
Enumeration date
10/11/2006
Last updated
02/20/2008
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