# PHYSICIAN DIAGNOSTIC SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013113638
- **Authorized official:** BRENDEN MANAWADU (BOM)
- **Authorized official phone:** (509) 946-0600

## Contact information

- **Practice address:** 1075 JADWIN AVE, SUITE 102, RICHLAND, WA 99352-3437
- **Practice address phone:** (509) 946-0600
- **Practice address fax:** (509) 943-7909
- **Mailing address:** PO BOX 1408, RICHLAND, WA 99352-1408
- **Mailing address phone:** (509) 946-0600
- **Mailing address fax:** (509) 943-7909

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/21/2007
- **Last updated:** 08/22/2020