Pacific Vascular Incorporated
NPI 1336019314ActiveOrganization· Physiological Laboratory· Port Ludlow, WA
Physiological Laboratory in Port Ludlow, Washington, registered in NPPES in November 2025, part of Pacific Vascular Incorporated. The authorized official on file is Bonnie M. Brown, RVT, Ceo. Enrolled in Medicare as part b supplier - independent diagnostic testing facility (idtf).
Overview
| NPI | 1336019314 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Pacific Vascular Incorporated |
| NPI issued | Nov 6, 2025 |
| Last updated in NPPES | Dec 2, 2025 |
| Certified by provider | Dec 2, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physiological Laboratory Primary | 293D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Independent Diagnostic Testing Facility (Idtf) (WA) |
|---|