Provider Demographics
NPI:1942246293
Name:DMITRI V VASIN MD
Entity Type:Organization
Organization Name:DMITRI V VASIN MD
Other - Org Name:RENAL REMISSION AND HYPERTENSION CONSULTANTS PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DMITRI
Authorized Official - Middle Name:V
Authorized Official - Last Name:VASIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-479-0349
Mailing Address - Street 1:840 CALLAHAN DR
Mailing Address - Street 2:STE A
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310
Mailing Address - Country:US
Mailing Address - Phone:360-479-0349
Mailing Address - Fax:360-479-0065
Practice Address - Street 1:840 CALLAHAN DR
Practice Address - Street 2:STE A
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310
Practice Address - Country:US
Practice Address - Phone:360-479-0349
Practice Address - Fax:360-479-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00038345207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7126907Medicaid
WA7126907Medicaid