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General NPI Number Information
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NPI Number | 1871538488
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Entity Type | Organization
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Legal Business Name | CARDIAC NUCLEAR MEDICINE ASSOCIATES, L.L.C.
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1415 E KINCAID ST
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City | MOUNT VERNON
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State | WA
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Zip | 98274-4126
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Country | US
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Telephone | 360-416-8455
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Fax | 360-416-8454
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Provider Business Mailing Address
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Address Line | 819 S 13TH ST
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City | MOUNT VERNON
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State | WA
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Zip | 98274-4112
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Country | US
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Telephone | 360-416-8455
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Fax | 360-416-8454
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | JULIE A GADBOIS
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Credential |
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Telephone | 360-336-9757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State | WA
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