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General NPI Number Information
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NPI Number | 1972914117
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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 | 05/09/2014
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Last Update Date | 05/09/2014
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Provider Practice Location Address
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Address Line | 98-1247 KAAHUMANU ST SUITE 320
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City | AIEA
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State | HI
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Zip | 96701-5311
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Country | US
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Telephone | 808-591-1504
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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 202
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City | SEATTLE
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State | WA
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Zip | 98105-5661
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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
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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 | W20190908
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License Number State | HI
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