Provider Demographics
NPI:1356907885
Name:VIRTUAL ALLIED REMOTE DIAGNOSTIC & CLINICAL SERVICES PLLC
Entity type:Organization
Organization Name:VIRTUAL ALLIED REMOTE DIAGNOSTIC & CLINICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IKE
Authorized Official - Middle Name:
Authorized Official - Last Name:UZOWULU
Authorized Official - Suffix:
Authorized Official - Credentials:RN / PSYCHIATRY
Authorized Official - Phone:281-979-4812
Mailing Address - Street 1:800 FAIRVIEW AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4412
Mailing Address - Country:US
Mailing Address - Phone:281-979-4812
Mailing Address - Fax:
Practice Address - Street 1:800 FAIRVIEW AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4412
Practice Address - Country:US
Practice Address - Phone:281-979-4812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN60804536OtherSTATE LICENSE RN