# MEDICAL IMAGING NORTHWEST - GOOD SAMARITAN HOSPITAL IMAGING ALLIANCE

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

## Provider details

- **NPI number:** 1760636930
- **Authorized official:** DR. DOUGLAS P SEILER MD (PRESIDENT)
- **Authorized official phone:** (253) 761-4200

## Contact information

- **Practice address:** 21110 SR 410 E, \#110, BONNEY LAKE, WA 98391-8457
- **Practice address phone:** (253) 841-4353
- **Practice address fax:** (253) 583-8630
- **Mailing address:** 1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
- **Mailing address phone:** (253) 761-4200
- **Mailing address fax:** (253) 583-8630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | 602760002 | NULL | Yes |

## Other

- **Enumeration date:** 11/13/2008
- **Last updated:** 12/14/2018