MEDICARE: BRAIN MATTERS IMAGING CENTERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center		WA

General Provider Information

NPI Number	:	1285850461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAIN MATTERS IMAGING CENTERS

Provider Business Mailing Address
First Line	:	1015 8TH AVE NORTH
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-3504
Country	:	US
Telephone Number	:	206-287-3900
Fax Number	:	206-287-3905

Provider Business Practice Location Address
First Line	:	1015 8TH AVE NORTH
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-3504
Country	:	US
Telephone Number	:	206-287-3900
Fax Number	:	206-287-3905

Authorized Official
Title or Position	:	CEO, PRESIDENT, CHAIRMAN
Name	:	MR. JOHN GOODHUE
Credential	:
Telephone Number	:	720-941-6428

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	08/22/2020

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