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Contact Information

EASTSIDE VASCULAR LLP
1135 116TH AVE NE STE 220
BELLEVUE, WA98004-4623
 Phone: 425-450-7007
 Fax: 425-450-0026
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for EASTSIDE VASCULAR LLP

NPI Number 1356471833
LBN Legal business name EASTSIDE VASCULAR LLP
Authorized official DUDLEY MOORHEAD - (PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/06/2007
Last updated 11/03/2009 - About 17 years ago
Identifiers
WA Medicaid 1098326
WA Medicaid 1371004
Other CB3636 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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