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General NPI Number Information
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NPI Number | 1891057493
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Entity Type | Organization
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Legal Business Name | ADVANCED IMAGING, LLC
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 2604 SOUTH MAIN ROAD
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City | LEBANON
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State | OR
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Zip | 97355
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Country | US
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Telephone | 541-570-1728
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Fax | 541-405-4020
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Provider Business Mailing Address
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Address Line | 2565 NW PENDLETON PLACE
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City | CORVALLIS
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State | OR
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Zip | 97330
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Country | US
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Telephone | 541-570-1728
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Fax | 541-405-4020
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Authorized Official
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Title or Position | TECHNOLOGIST / ADMINISTRATOR
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Name | MRS. KIMBERLEY ANNE BARCLAY
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Credential | MHA
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Telephone | 541-570-1728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Internal Medicine Physician
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License Number |
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License Number State |
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