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General NPI Number Information
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NPI Number | 1174418461
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Entity Type | Organization
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Legal Business Name | EXIGES IMAGING OF IDAHO LLC
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1420 E 3RD AVE STE 203
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City | POST FALLS
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State | ID
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Zip | 83854-7580
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Country | US
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Telephone | 888-480-9048
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Fax |
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Provider Business Mailing Address
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Address Line | 8800 SE SUNNYSIDE RD STE 214N
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City | CLACKAMAS
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State | OR
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Zip | 97015-5704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARY KOFSTAD
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Credential |
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Telephone | 406-671-8719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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