PACIFIC VASCULAR INCORPORATED
NPI 1336019314
Physiological Laboratory in Port Ludlow, WA

Active since November 06, 2025
117 VILLAGE WAY, PORT LUDLOW, WA 98365(425) 486-8868(425) 486-8976 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 2, 2025, Nov 6, 2025 (2 updates tracked since 2025).

About Pacific Vascular Incorporated NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC VASCULAR INCORPORATED (NPI 1336019314) is a healthcare organization registered as a physiological laboratory in Port Ludlow, Washington and active in the NPI registry since November 2025. The organization lists Bonnie M Brown, Ceo, as its authorized official.

NPPES Registry Identity

NPI1336019314
Entity TypeOrganization
Primary Taxonomy293D00000X
Legal Business NamePACIFIC VASCULAR INCORPORATED
Location Address117 VILLAGE WAYPort Ludlow, WA 98365-8792
Mailing Address11714 N Creek Pkwy N Ste 100Bothell, WA 98011-8099 · (425) 486-8868 · Fax (425) 486-8976
Fax(425) 486-8976
Organization SubpartYes
Authorized OfficialBonnie M BrownCeo · (425) 398-7781
Enumeration DateNovember 6, 2025
Last NPPES UpdateDecember 2, 20252 updates tracked since enumeration
NPPES CertifiedDecember 2, 2025
NPI 1336019314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysiological LaboratoryLaboratories
Taxonomy Code293D00000X
Definition

A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.

117 VILLAGE WAY, Port Ludlow, WA 98365

Other Names 1

Other NamePacific Vascular-port Ludlow

Other Identifiers 1

Medicaid7015852WA

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336019314, enumerated as an "organization" on November 06, 2025.

The provider is located at 117 VILLAGE WAY PORT LUDLOW, WA 98365 and the phone number is (425) 486-8868.

Physiological Laboratory with taxonomy code 293D00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.