Organization · Type 2 NPI

Fayetteville Dialysis

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Tacoma, WA

NPI number 1811315971 Active

Practice location

1423 Pacific Ave
Tacoma, WA 98402-4203

Mailing address

509 E Millsap Rd, Ste 111
Fayetteville, AR 72703-4067

Specialties and licenses

TaxonomyCodeLicense
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary 261QE0700X04D0922946 (AR)
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X1295913416 (AR)

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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About NPI 1811315971

Fayetteville Dialysis's National Provider Identifier is 1811315971, issued on Apr 4, 2014. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Tacoma, WA. The record was last updated on Apr 4, 2014.