Healthcare Provider Details

I. General information

NPI: 1417600271
Provider Name (Legal Business Name): PERFECTION ULTRASOUND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 W KENNEWICK AVE STE 8
KENNEWICK WA
99336-3830
US

IV. Provider business mailing address

5801 W 19TH AVE
KENNEWICK WA
99338-2187
US

V. Phone/Fax

Practice location:
  • Phone: 509-591-8528
  • Fax:
Mailing address:
  • Phone: 509-591-8528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ANNA SPENCER
Title or Position: REGISTERED SONOGRAPHER
Credential: ARDMS
Phone: 509-591-8528