Provider Demographics
NPI:1558985556
Name:VENTRI MEDICINE
Entity Type:Organization
Organization Name:VENTRI MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:NICOLE FIRMINGER
Authorized Official - Last Name:EICKMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:425-802-8035
Mailing Address - Street 1:17311 135TH AVE NE STE C800
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-4349
Mailing Address - Country:US
Mailing Address - Phone:425-802-8035
Mailing Address - Fax:
Practice Address - Street 1:17311 135TH AVE NE STE C800
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-4349
Practice Address - Country:US
Practice Address - Phone:425-802-8035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care