Healthcare Provider Details

I. General information

NPI: 1992976021
Provider Name (Legal Business Name): SPOKANE ADVANCED IMAGING INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12606 E MISSION AVE
SPOKANE VALLEY WA
99216-3421
US

IV. Provider business mailing address

11100 NE 8TH ST STE 500
BELLEVUE WA
98004-4472
US

V. Phone/Fax

Practice location:
  • Phone: 509-473-5851
  • Fax: 509-473-5880
Mailing address:
  • Phone: 425-637-3378
  • Fax: 425-637-7535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT HALLIDAY
Title or Position: MEMBER OF OWNER
Credential:
Phone: 425-637-3378