# COAST IMAGING SOUTH PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coast Imaging South PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952158925
- **Authorized official:** SANDY CLEMENS (AO)
- **Authorized official phone:** (253) 386-3607

## Contact information

- **Practice address:** 1519 3RD ST SE STE 103, PUYALLUP, WA 98372-3742
- **Practice address phone:** (425) 386-3607
- **Mailing address:** 8012 112TH STREET CT E STE 120, PUYALLUP, WA 98373-7856
- **Mailing address phone:** (425) 386-3607

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/06/2024
- **Last updated:** 05/06/2024