Organization
OLYMPIA OPEN MRI LLC
Active
Organization
OLYMPIA OPEN MRI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN MICHAEL GOLDEN (MANAGING MEMBER)
(503) 246-2808
Entity
Organization
Contact information
Practice address
669 WOODLAND SQUARE LOOP SE, STE D, LACEY, WA 98503-1038
(360) 413-9393
(360) 413-9365
Mailing address
10151 SW BARBUR BLVD, STE 105D, PORTLAND, OR 97219-5911
(503) 246-2808
(503) 246-2681
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7200116
—
WA
Enumeration date
03/24/2006
Last updated
10/10/2007
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