Organization
WESTERN RADIOLOGY IMAGING LLC
Active
Organization
WESTERN RADIOLOGY IMAGING LLC
Active
Other names
Via Radiology - Meridian Pavilion
Organization subpart
No
Provider details
NPI number
Authorized official
LORI GANAL (CONTROLLER)
(206) 365-4100
Entity
Organization
Contact information
Practice address
11011 MERIDIAN AVE N, SUITE 101, SEATTLE, WA 98133-8967
(206) 306-1011
(206) 306-1019
Mailing address
PO BOX 24722, SEATTLE, WA 98124-0722
(206) 306-1011
(206) 306-1019
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
UBI 602469354
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206464
GROUP L&I
WA
01
—
602469354
UBI#
WA
01
—
613160100
OWCP
WA
01
—
7028WE
REGENCE GROUP#
WA
05
—
7135825
—
WA
01
—
DF0569
RR MEDI
WA
Enumeration date
08/31/2006
Last updated
03/25/2019
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