Provider Demographics
NPI:1457781825
Name:NORTHWEST CLINICAL PATHOLOGY
Entity Type:Organization
Organization Name:NORTHWEST CLINICAL PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOYT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-734-2800
Mailing Address - Street 1:3614 MERIDIAN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1748
Mailing Address - Country:US
Mailing Address - Phone:360-734-2800
Mailing Address - Fax:
Practice Address - Street 1:3614 MERIDIAN ST STE 100
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1748
Practice Address - Country:US
Practice Address - Phone:360-734-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST PATHOLOGY, PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Multi-Specialty
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical PathologyGroup - Multi-Specialty