# PUYALLUP IMAGING CONSULTANTS LLC

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

## Provider details

- **NPI number:** 1083911127
- **Authorized official:** MR. NELSON GOEHLE (CEO)
- **Authorized official phone:** (253) 435-5195

## Contact information

- **Practice address:** 12623 MERIDIAN E, SUITE A1, PUYALLUP, WA 98373-3469
- **Practice address phone:** (253) 435-5195
- **Practice address fax:** (253) 435-5482
- **Mailing address:** 12623 MERIDIAN E, SUITE A1, PUYALLUP, WA 98373-3469
- **Mailing address phone:** (253) 435-5195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | 603071995 | WA | Yes |

## Other

- **Enumeration date:** 02/25/2011
- **Last updated:** 02/25/2011