Organization · NPI-2
Neurotech Northwest, LLC
Physiological Laboratory · Yakima, WA
NPI number1598407488
StatusActive
Last updated in NPPESApr 11, 2022
Details
- NPI
- 1598407488
- Entity type
- Organization (NPI-2)
- Legal business name
- Neurotech Northwest, LLC
- Organization subpart
- No
- Enumeration date
- Apr 11, 2022
- Certification date
- Apr 11, 2022
- Last updated
- Apr 11, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 293D00000X | Physiological Laboratory | – | – | Yes |
| 2472E0500X | Technician, Other, EEG | – | – | |
| 261QS1200X | Clinic/Center, Sleep Disorder Diagnostic | – | – | |
| 335V00000X | Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | – | – |
Practice location
402 E Yakima Ave Ste 447cYakima, WA 98901-5407
Phone 262-875-6593 · Fax 262-754-0897
Mailing address
626 W Moreland BlvdWaukesha, WI 53188-2433
Phone 866-374-7648 · Fax 262-754-0897
Authorized official
Kristine Lisa Wildner
Director Of Contracting & Research
2628756572
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