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Organization

CYTOLAB PATHOLOGY SERVICES INC PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONOLD SAMUEL NAKONECHNY M.D. (PRESIDENT)
(425) 712-8020
Entity
Organization

Contact information

Practice address
6825 216TH ST SW, LYNNWOOD, WA 98036-7379
(425) 712-8020
(425) 712-8349
Mailing address
PO BOX 100559, FLORENCE, SC 29501-0559
(843) 664-4300
(843) 664-4308

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
MD00012785
WA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD00012785
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12538
BCBS
WA
05
7015084
WA
Enumeration date
04/14/2006
Last updated
12/20/2007
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