| NPI | 1801869383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA STEPHENS Credentialing Specialist 509-961-3849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: WA RT00005601) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2021-09-10 |