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Organization
TELLICA IMAGING - WASHINGTON LLC
Active
Organization
TELLICA IMAGING - WASHINGTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD ISAACSON (PRESIDENT)
(801) 442-6000
Entity
Organization
Contact information
Practice address
421 EAST MAIN STREET, AUBURN, WA 98002
(253) 204-2530
(253) 617-1296
Mailing address
36 S STATE ST, SALT LAKE CITY, UT 84111-1401
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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