Organization
PUGET SOUND INSTITUTE OF PATHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH A MECKLER M.D. (MANAGING MEMBER)
(206) 622-7747
Entity
Organization
Contact information
Practice address
1001 SW KLICKITAT WAY, SUITE 205, SEATTLE, WA 98134-1161
(206) 622-7747
(206) 467-1470
Mailing address
PO BOX 34245, SEATTLE, WA 98124-1245
(206) 622-7747
(206) 467-1470
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
50D0633091
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7066947
—
WA
01
—
81407/161839
LABOR & INDUSTRIES
WA
Enumeration date
08/02/2010
Last updated
08/02/2010
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