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General NPI Number Information
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NPI Number | 1609811322
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Entity Type | Organization
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Legal Business Name | COLUMBIA BASIN IMAGING PC
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 11/01/2012
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Provider Practice Location Address
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Address Line | 888 SWIFT BLVD
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City | RICHLAND
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State | WA
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Zip | 99352
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Country | US
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Telephone | 509-943-5616
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Fax | 509-943-9272
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Provider Business Mailing Address
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Address Line | PO BOX 5230
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City | PASCO
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State | WA
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Zip | 99302-5201
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Country | US
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Telephone | 509-943-5616
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Fax | 509-943-9272
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Authorized Official
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Title or Position | DIRECTOR
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Name | DWANE T BRITTAIN
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Credential | MD
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Telephone | 509-943-5616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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