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NPI Code Detail

MEDICARE: EPIC IMAGING PC

MEDICARE: EPIC IMAGING PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700983319
Entity Type Code : Organization
Provider Name (Legal Business Name) : EPIC IMAGING PC
Provider Business Mailing Address
First Line : 233 NE 102ND AVENUE
Second Line :
City : PORTLAND
State : OR
Zip : 97220-4106
Country : US
Telephone Number : 503-253-1105
Fax Number : 503-535-8002
Provider Business Practice Location Address
First Line : 233 NE 102ND AVENUE
Second Line :
City : PORTLAND
State : OR
Zip : 97220-4106
Country : US
Telephone Number : 503-535-8300
Fax Number : 503-535-8399
Authorized Official
Title or Position : ADMINISTRATIVE ASSISTANT
Name : MRS. BRENDA YEAGER
Credential :
Telephone Number : 503-535-7009
Provider Enumeration Date : 09/19/2006
Last Update Date : 09/23/2021

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Practice Location Address:
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1962518662 — DR. WARREN SCOTT TUBBS MD
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1700984069 — DR. GERALD LLOYD WARNOCK MD
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1346637063 — MR. THOMAS ANDREW VANDERJAGT MD, PH.D
Practice Location Address:
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Directions to “EPIC IMAGING PC ” Practice Location

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