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General NPI Number Information
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NPI Number | 1902802234
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Entity Type | Organization
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Legal Business Name | HAWAII PET IMAGING, LLC.
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 1401 S BERETANIA ST STE. 107
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City | HONOLULU
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State | HI
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Zip | 96814-1870
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Country | US
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Telephone | 808-590-1504
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Fax | 808-591-1506
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Provider Business Mailing Address
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Address Line | 5001 25TH AVE NE STE. 202
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City | SEATTLE
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State | WA
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Zip | 98105
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Country | US
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Telephone | 206-272-3580
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Fax | 206-272-3588
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. SCOTT B. HALLIDAY
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Credential |
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Telephone | 206-272-3580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | 10667130
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License Number State | HI
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