Provider Demographics
NPI:1619460268
Name:PACIFIC KIDNEY & HYPERTENSION, LLC
Entity Type:Organization
Organization Name:PACIFIC KIDNEY & HYPERTENSION, LLC
Other - Org Name:SNOHOMISH KIDNEY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIULLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:855-397-0197
Mailing Address - Street 1:1820 E RAY RD STE B201
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8720
Mailing Address - Country:US
Mailing Address - Phone:855-397-0197
Mailing Address - Fax:
Practice Address - Street 1:2707 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3528
Practice Address - Country:US
Practice Address - Phone:425-339-5413
Practice Address - Fax:425-339-4213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty