# PENINSULA MEDICAL IMAGING, PLLC

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

## Provider details

- **NPI number:** 1356416705
- **Authorized official:** DR. MICHAEL SCOT FISHMAN M.D. (OWNER)
- **Authorized official phone:** (360) 582-0590

## Contact information

- **Practice address:** 675 N. FIFTH AVE, SUITE 2B, SEQUIM, WA 98382-3201
- **Practice address phone:** (360) 582-0590
- **Practice address fax:** (360) 582-0172
- **Mailing address:** PO BOX 24322, SEATTLE, WA 98124-0322
- **Mailing address phone:** (360) 582-0590
- **Mailing address fax:** (360) 582-0172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | MD00029650 | WA | Yes |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 03/03/2008