Provider Demographics
NPI:1467193490
Name:VENIDIRECT LLC
Entity Type:Organization
Organization Name:VENIDIRECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEATON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:832-746-6042
Mailing Address - Street 1:1155 SW MORRISON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2254
Mailing Address - Country:US
Mailing Address - Phone:800-803-8263
Mailing Address - Fax:
Practice Address - Street 1:1155 SW MORRISON ST STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2254
Practice Address - Country:US
Practice Address - Phone:800-803-8263
Practice Address - Fax:971-777-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty