Healthcare Provider Details

I. General information

NPI: 1063280865
Provider Name (Legal Business Name): ISLAND COUNTY ULTRASOUND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 NE CENTER ST
COUPEVILLE WA
98239-3466
US

IV. Provider business mailing address

902 NE CENTER ST
COUPEVILLE WA
98239-3466
US

V. Phone/Fax

Practice location:
  • Phone: 206-866-8405
  • Fax:
Mailing address:
  • Phone: 206-866-8405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: KULVINDER KAUR
Title or Position: OWNER/OPERATOR
Credential: RDMS, RVT
Phone: 360-720-4463