Provider Demographics
NPI:1588748123
Name:PRECISION VEIN CENTER
Entity type:Organization
Organization Name:PRECISION VEIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:EPHRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-365-4100
Mailing Address - Street 1:10700 MERIDIAN AVE N
Mailing Address - Street 2:SUITE 505
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9008
Mailing Address - Country:US
Mailing Address - Phone:206-365-4100
Mailing Address - Fax:206-368-6898
Practice Address - Street 1:10700 MERIDIAN AVE N
Practice Address - Street 2:SUITE 505
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9008
Practice Address - Country:US
Practice Address - Phone:206-365-4100
Practice Address - Fax:206-368-6898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA=========OtherEIN