Organization
MEDICAL IMAGING ON 1ST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE E. DWIGHT COO (CHIEF OPERATIONS OFFICER)
(253) 761-4200
Entity
Organization
Contact information
Practice address
33915 1ST WAY S, SUITE 130, FEDERAL WAY, WA 98003-4551
(253) 761-4200
(253) 383-3553
Mailing address
PO BOX 1535, TACOMA, WA 98401-1535
(253) 761-4200
(253) 383-3553
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
602910970
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3391ME
REGENCE
WA
05
—
7146921
—
WA
01
—
DQ1259
RR MEDICARE
WA
01
—
G8881464
MEDICARE PTAN
WA
01
—
O249518
LABOR & INDUSTRIES , CRIME VICTIMS COMPENSATION
WA
Enumeration date
05/19/2009
Last updated
01/19/2011
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