Organization
DIAGNOSTIC IMAGING, NW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SHELEY MD (DIRECTOR)
(503) 413-7111
Entity
Organization
Contact information
Practice address
1015 NW 22ND AVE, STE T240, PORTLAND, OR 97210-3025
(503) 413-7127
(503) 413-8169
Mailing address
PO BOX 3730, DINW#103, PORTLAND, OR 97208-3730
(800) 878-6698
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130317
—
OR
01
—
CF9101
RAILROAD MEDICARE
OR
Enumeration date
06/11/2006
Last updated
07/21/2022
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