Healthcare Provider Details

I. General information

NPI: 1679511240
Provider Name (Legal Business Name): SPOKANE IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E ROWAN AVE SUITE 170
SPOKANE WA
99207-1202
US

IV. Provider business mailing address

PO BOX 94217
SEATTLE WA
98124-6517
US

V. Phone/Fax

Practice location:
  • Phone: 509-482-4300
  • Fax: 509-482-4301
Mailing address:
  • Phone: 509-747-5191
  • Fax: 509-473-4992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT B HALLIDAY
Title or Position: PRESIDENT OF THE MEMBER
Credential:
Phone: 425-637-3378