Organization
BOBODZHANOV INC
Active
Organization
BOBODZHANOV INC
Active
Other names
Ultraecho
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXI BOBODZHANOV RDMS, RDCS (PRESIDENT CEO)
(206) 621-4722
Entity
Organization
Contact information
Practice address
440 W BRODERICK DR, MERIDIAN, ID 83646-6427
(206) 786-6936
(206) 621-4176
Mailing address
440 W BRODERICK DR, MERIDIAN, ID 83646-6427
(206) 786-6936
(206) 621-4176
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
Primary
—
—
2471S1302X
Sonography Radiologic Technologist
—
—
2471V0105X
Vascular Sonography Radiologic Technologist
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
N/A PORTABLE U/S
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0185002
LABOR AND INDUSTRIES
WA
01
—
47001664
RAILROAD MEDICARE
WA
01
—
568397002
GROUP HEALTH COOPERATIVE
WA
05
—
7115389
—
WA
01
—
7130BO
REGENCE
WA
Enumeration date
11/20/2006
Last updated
03/08/2017
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