Organization
FASTEX ADVANCED MOBILE IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA STEPHENS (CREDENTIALING SPECIALIST)
(509) 961-3849
Entity
Organization
Contact information
Practice address
106 E E ST, YAKIMA, WA 98901-2312
(509) 972-8617
(509) 452-8418
Mailing address
PO BOX 8051, YAKIMA, WA 98908-0051
(509) 469-1903
(509) 469-1905
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0195224
LABOR AND INDUSTRIES
WA
05
—
7127954
—
WA
Enumeration date
08/10/2005
Last updated
09/10/2021
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