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General NPI Number Information
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NPI Number | 1215758925
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Entity Type | Organization
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Legal Business Name | COAST IMAGING NORTH PLLC
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 18730 33RD AVE W
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City | LYNNWOOD
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State | WA
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Zip | 98037-4756
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Country | US
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Telephone | 425-386-3607
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Fax | 425-386-3608
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Provider Business Mailing Address
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Address Line | 8012 112TH STREET CT E STE 120
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City | PUYALLUP
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State | WA
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Zip | 98373-7856
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Country | US
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Telephone | 425-386-3607
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Fax | 425-386-3608
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SANDY CLEMENS
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Credential |
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Telephone | 425-386-3607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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