Provider Demographics
NPI:1376308106
Name:SLEEP DIAGNOSTICS NW PLLC
Entity Type:Organization
Organization Name:SLEEP DIAGNOSTICS NW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOCKENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-631-4437
Mailing Address - Street 1:16410 SMOKEY POINT BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-7079
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16410 SMOKEY POINT BLVD STE 106
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-7079
Practice Address - Country:US
Practice Address - Phone:619-405-3219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty