Healthcare Provider Details

I. General information

NPI: 1831285501
Provider Name (Legal Business Name): COLUMBIA PACIFIC IMAGING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 EXCHANGE ST STE 170
ASTORIA OR
97103-3419
US

IV. Provider business mailing address

PO BOX 5469
VANCOUVER WA
98668-5469
US

V. Phone/Fax

Practice location:
  • Phone: 360-699-8158
  • Fax: 360-699-3372
Mailing address:
  • Phone: 360-699-8158
  • Fax: 360-699-3372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TRACY TIMMONS
Title or Position: ACCOUNTS MANAGER
Credential:
Phone: 360-699-8158