Provider Demographics
NPI:1598868127
Name:HIGHLINE SLEEP DISORDER CENTER, LLC
Entity Type:Organization
Organization Name:HIGHLINE SLEEP DISORDER CENTER, LLC
Other - Org Name:HIGHLINE SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-852-0078
Mailing Address - Street 1:16233 SYLVESTER RD SW
Mailing Address - Street 2:SUITE G-70
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166
Mailing Address - Country:US
Mailing Address - Phone:206-988-5779
Mailing Address - Fax:206-246-2380
Practice Address - Street 1:16233 SYLVESTER RD SW
Practice Address - Street 2:SUITE G-70
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166
Practice Address - Country:US
Practice Address - Phone:206-988-5779
Practice Address - Fax:206-246-2380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8856910Medicare PIN
WAGAB33143Medicare PIN