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Active NPI 1700329828 Organization (Entity Type 2)

Braincare, Llc

Physiological Laboratory • Bothell, WA

About Braincare, Llc NPI 1700329828 Summary

Braincare, Llc is a verified healthcare organization specializing in Physiological Laboratory operating in Bothell, WA. Located at 19909 120TH AVE NE STE 203, this facility provides patient care and medical services under National Provider Identifier (NPI) 1700329828.

Administrative operations and authorized compliance are overseen by Janice Shock (Sr Director Of Operations).

The facility is associated with 10 linked healthcare practitioners providing clinical services. In addition to its main center, the organization maintains 2 secondary practice locations in the region.

Facility Location & Contact Primary Location

Facility Address

19909 120th Ave Ne Ste 203

Bothell, WA 980118242

Telephone 8668482522
Fax 8772901544

Authorized Official Information

Authorized Contact Name

Janice Shock

Title / Role

Sr Director Of Operations

Official Telephone

2145323757

Facility Classifications & Specialties

Physiological Laboratory Primary Taxonomy

NUCC Taxonomy Code: 293D00000X

A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

10 Linked
Keyanna Jones NPI 1053761486

Behavior Analyst

Seattle, WA

View Practitioner Profile →
Bonnie Wu NPI 1134590946

Behavior Analyst

Seattle, WA

View Practitioner Profile →
Amanda Harris NPI 1194175125

Technician, Other

Seattle, WA

View Practitioner Profile →

Behavior Analyst

Seattle, WA

View Practitioner Profile →
Caroline Wait NPI 1245687300

Technician, Other

Seattle, WA

View Practitioner Profile →
Amanda Bosch NPI 1285000935

Behavior Analyst

Seattle, WA

View Practitioner Profile →

Secondary Facility Locations

Verified branch offices, satellite clinics, and regional practice locations

2 Branches

1100 Dexter Ave N, Ste 100 (Unit 165d)

Seattle, WA 981093598

Phone: 8668482522

11820 Northup Way Ste 200

Bellevue, WA 980051974

Phone: 8668482522

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

8 Historical Events
📍
Updated Practice Location November 15, 2018

Registered at 19909 120TH AVE NE STE 203, BOTHELL, WA 980118242 (Tel: 8668482522)

📍
Updated Practice Location July 03, 2018

Registered at 11820 NORTHUP WAY STE 200, BELLEVUE, WA 980051974 (Tel: 8668482522)

NPI Profile Active November 21, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location November 21, 2016

Registered at 1100 DEXTER AVE N, STE 100 (UNIT 165D), SEATTLE, WA 981093598 (Tel: 8668482522)

📍
Updated Business Mailing Address November 21, 2016

Registered at 2670 FIREWHEEL DR, STE B, FLOWER MOUND, TX 750284601 (Tel: 8668482522)

🏛️
Organization / Clinic Name Updated November 21, 2016

Operating as BRAINCARE, LLC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 21, 2016

Physiological Laboratory

🟢
Initial NPI Registration & Enumeration November 21, 2016

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1700329828
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: November 21, 2016
Last Update: November 15, 2018

Mailing Address

2670 Firewheel Dr, Ste B

Flower Mound, TX 750284601

Phone: 8668482522

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.