Provider Demographics
NPI:1255312690
Name:MINOR & JAMES MEDICAL PLLC
Entity Type:Organization
Organization Name:MINOR & JAMES MEDICAL PLLC
Other - Org Name:LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-386-9500
Mailing Address - Street 1:PO BOX 3489
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98114-3489
Mailing Address - Country:US
Mailing Address - Phone:206-386-9500
Mailing Address - Fax:206-386-9605
Practice Address - Street 1:515 MINOR AVE
Practice Address - Street 2:#100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2120
Practice Address - Country:US
Practice Address - Phone:206-386-9500
Practice Address - Fax:206-386-9605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA144182OtherLABOR & INDUSTRIES