Organization
PUGET SOUND INSTITUTE OF PATHOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH A MECKLER MD (MANAGING PARTNER)
(206) 622-7747
Entity
Organization
Contact information
Practice address
1001 KLICKITAT WAY SW #205, PUGET SOUND INSTITUTE OF PATHOLOGY, SEATTLE, WA 98134
(206) 622-7747
(206) 467-1470
Mailing address
PO BOX 34245, PSIP PLLC, SEATTLE, WA 98124-1245
(206) 622-7747
(206) 467-1470
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
CLIA 5000633091
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161839
DEPT OF LABOR INDUSTRIES
WA
05
—
7066947
—
WA
01
—
81407
DEPT OF LABOR INDUSTRIES
WA
Enumeration date
11/15/2005
Last updated
07/02/2012
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