Provider Demographics
NPI:1013621150
Name:PACIFIC NW FERTILITY AND IVF SPECIALISTS. I. PLLC
Entity Type:Organization
Organization Name:PACIFIC NW FERTILITY AND IVF SPECIALISTS. I. PLLC
Other - Org Name:PACIFIC NW FERTILITY AND IVF SPECIALISTS, I. PLLC EGG BANK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEY
Authorized Official - Middle Name:LIEW
Authorized Official - Last Name:SAECHAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-515-0054
Mailing Address - Street 1:1101 MADISON STREET, STE 1050
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-515-0000
Mailing Address - Fax:206-515-0001
Practice Address - Street 1:1101 MADISON STREET, STE 1050
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-515-0000
Practice Address - Fax:206-515-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/InfertilityGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1518910124OtherNPI