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Physicians Radiology Diagnostic Radiology

Provider NPI: 1215924774

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
19020 33RD AVE W SUITE 210 LYNNWOOD, WA 98036-4746 US
Tel: 425-563-1500  Fax: 425-563-1374

Business Mailing Address:
19020 33RD AVE W SUITE 210 LYNNWOOD, WA 98036-4746 US
Tel: 425-563-1500  Fax: 425-563-1374

NPI Information:
NPI: 1215924774
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Diagnostic Radiology

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2085R0202X





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