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Technologists, Technicians & Other Technical Service Providers Radiologic Technologist Radiography

Provider NPI: 1215074885

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 503-220-8262  Fax: --

Business Mailing Address:
Tel: 503-220-8262  Fax: --

NPI Information:
NPI: 1215074885
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y2471C3402XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2471C3402X





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