Provider Demographics
NPI:1881913812
Name:VALLEY DIGITAL DIAGNOSTICS L.L.C.
Entity type:Organization
Organization Name:VALLEY DIGITAL DIAGNOSTICS L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PFEIFFER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:253-854-5461
Mailing Address - Street 1:20514 SE 261ST PL
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-6105
Mailing Address - Country:US
Mailing Address - Phone:253-854-5461
Mailing Address - Fax:
Practice Address - Street 1:20514 SE 261ST PL
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-6105
Practice Address - Country:US
Practice Address - Phone:253-854-5461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034342291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory