Provider Demographics
NPI:1295057230
Name:NATURAL MOLECULAR TESTING CORPORATION
Entity type:Organization
Organization Name:NATURAL MOLECULAR TESTING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:REMBERT
Authorized Official - Last Name:FESSENDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-630-9922
Mailing Address - Street 1:223 SW 41ST ST
Mailing Address - Street 2:UNIT#5
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057
Mailing Address - Country:US
Mailing Address - Phone:888-442-8881
Mailing Address - Fax:
Practice Address - Street 1:223 SW 41ST ST
Practice Address - Street 2:UNIT#5
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057
Practice Address - Country:US
Practice Address - Phone:888-442-8881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA50D1092274291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory