Organization
DYNACARE NORTHWEST INC
Active
Other names
Pacific Walk in Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM B HAYES (CFO EVP TREASURER)
(800) 222-7566
Entity
Organization
Contact information
Practice address
3928 PACIFIC AVE SE, LACEY, WA 98503-1109
(360) 456-5462
Mailing address
PO BOX 2240, BURLINGTON, NC 27216-2240
(800) 222-7566
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50D0993663
CLIA
—
Enumeration date
07/28/2008
Last updated
07/28/2008
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