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General NPI Number Information
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NPI Number | 1649575986
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Entity Type | Organization
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Legal Business Name | OLYMPIC RADIOLOGY LLC
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 01/18/2011
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Provider Practice Location Address
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Address Line | 22180 OLYMPIC COLLEGE WAY NW
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City | POULSBO
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State | WA
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Zip | 98370
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Country | US
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Telephone | 360-479-6555
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Fax | 360-479-8327
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Provider Business Mailing Address
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Address Line | 2700 CLARE AVE
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City | BREMERTON
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State | WA
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Zip | 98310-3330
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Country | US
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Telephone | 360-479-6555
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Fax | 360-479-8327
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MICHELE D SAUER
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Credential |
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Telephone | 360-479-6555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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