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General NPI Number Information
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NPI Number | 1982787081
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC RADIOLOGY CONSULTANTS, INC. P.S.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 330 S STILLAGUAMISH AVE
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City | ARLINGTON
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State | WA
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Zip | 98223-1642
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Country | US
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Telephone | 306-435-0504
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Fax |
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Provider Business Mailing Address
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Address Line | 1770 NW 58TH ST STE 124
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City | SEATTLE
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State | WA
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Zip | 98107-3048
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Country | US
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Telephone | 206-789-5583
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Fax | 206-789-1855
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SUE E HARRIS
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Credential |
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Telephone | 206-789-5583
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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 | MD00011079
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License Number State | WA
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