Healthcare Provider Details
I. General information
NPI: 1316973514
Provider Name (Legal Business Name): ALLIANCE HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/23/2006
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 HOSPITAL DR
SEDRO WOOLLEY WA
98284-4327
US
IV. Provider business mailing address
8300 W SUNRISE BLVD
PLANTATION FL
33322-5406
US
V. Phone/Fax
- Phone: 360-856-7496
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0208X |
| Taxonomy | Mobile Radiology Clinic/Center |
| License Number | WN-M0222-1 |
| License Number State | WA |
VIII. Authorized Official
Name:
LAURA
KASSA
Title or Position: SR VICE PRESIDENT
Credential:
Phone: 904-300-2777