Healthcare Provider Details

I. General information

NPI: 1982236469
Provider Name (Legal Business Name): INLAND IMAGING ASSOCIATES PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 12TH AVE S
SEATTLE WA
98144-2712
US

IV. Provider business mailing address

801 S STEVENS ST
SPOKANE WA
99204-2654
US

V. Phone/Fax

Practice location:
  • Phone: 509-363-7788
  • Fax:
Mailing address:
  • Phone: 509-363-7788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LORI WALTERS
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 509-363-7313