Organization
EXCEL IMAGING LLC
Active
Organization
EXCEL IMAGING LLC
Active
Other names
South Center Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
BETH LUPO (PROVIDER RELATIONS SUPERVISOR)
(586) 412-4423
Entity
Organization
Contact information
Practice address
415 BAKER BLVD, SUITE 100, TUKWILA, WA 98188
(206) 439-8828
(206) 439-8878
Mailing address
415 BAKER BLVD, SUITE 110, TUKWILA, WA 98188
(206) 439-8828
(206) 439-8878
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7119183
—
WA
Enumeration date
11/02/2006
Last updated
08/22/2020
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