Organization
PUYALLUP OPEN IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD A ZIMMER (MANAGING PARTNER)
(877) 630-9804
Entity
Organization
Contact information
Practice address
12623 MERIDIAN E, STE A1, PUYALLUP, WA 98373-3469
(253) 864-6531
(253) 864-6539
Mailing address
2784 12TH ST SE, SALEM, OR 97302-3159
(877) 630-9804
(503) 586-1300
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7114465
—
WA
Enumeration date
11/09/2005
Last updated
08/22/2020
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