Organization
PACIFIC NORTHWEST RADIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BURT J LOESSBERG (ADMINISTRATOR)
(541) 687-7134
Entity
Organization
Contact information
Practice address
1915 E REZANOF DR, KODIAK, AK 99615-6602
(907) 486-3281
(907) 486-2336
Mailing address
PO BOX 26570, FRESNO, CA 93729-6570
(541) 687-7134
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
314344
AK
Other
Enumeration date
05/22/2007
Last updated
08/22/2020
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