Healthcare Provider Details

I. General information

NPI: 1609863372
Provider Name (Legal Business Name): DIAGNOSTIC SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2005
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 116TH AVE NE STE 207
BELLEVUE WA
98004-3063
US

IV. Provider business mailing address

PO BOX 33879
SEATTLE WA
98133-0879
US

V. Phone/Fax

Practice location:
  • Phone: 425-235-5984
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: MR. ILYA VISHEVSKY
Title or Position: PRESIDENT
Credential: RDMS
Phone: 425-235-5984