Provider Demographics
NPI:1689800542
Name:REM MEDICAL - CLINICAL RESEARCH
Entity Type:Organization
Organization Name:REM MEDICAL - CLINICAL RESEARCH
Other - Org Name:REM MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:N
Authorized Official - Last Name:BENAROYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-285-5100
Mailing Address - Street 1:190 QUEEN ANNE AVE N
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4968
Mailing Address - Country:US
Mailing Address - Phone:206-285-5100
Mailing Address - Fax:206-260-2879
Practice Address - Street 1:3134 N SWAN RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1227
Practice Address - Country:US
Practice Address - Phone:520-909-2007
Practice Address - Fax:520-318-1144
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REM MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty