| Revolution Neurotesting Pllc | |
|
2737 78th Ave Se Ste 100 Mercer Island WA 98040-2843 | |
| (206) 695-2707 | |
| Not Available |
| Full Name | Revolution Neurotesting Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2737 78th Ave Se Ste 100, Mercer Island, Washington |
| Authorized Official Name and Position | Richard E Repass (OWNER) |
| Authorized Official Contact | 2066952707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revolution Neurotesting Pllc Po Box 1775 Mercer Island WA 98040-1775 Ph: (952) 417-6773 | Revolution Neurotesting Pllc 2737 78th Ave Se Ste 100 Mercer Island WA 98040-2843 Ph: (206) 695-2707 |
| NPI Number | 1790543833 |
|---|---|
| Provider Enumeration Date | 03/12/2024 |
| Last Update Date | 03/12/2024 |
| Certification Date | 03/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790543833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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