Healthcare Provider Details

I. General information

NPI: 1144345711
Provider Name (Legal Business Name): SPOKANE ADVANCED IMAGING INSTITUTE , LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W 5TH AVE SUITE 150
SPOKANE WA
99204-2966
US

IV. Provider business mailing address

PO BOX 94131
SEATTLE WA
98124-6431
US

V. Phone/Fax

Practice location:
  • Phone: 509-363-1063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: MR. SCOTT B HALLIDAY
Title or Position: CEO
Credential:
Phone: 425-637-3378