Organization
BDC RADIOLOGY INC PS
Active
Other names
BREAST DIAGNOSTIC CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN T BLACKWELDER MD (PRESIDENT)
(253) 735-1991
Entity
Organization
Contact information
Practice address
1268 E MAIN ST, SUITE 1, AUBURN, WA 98002-5748
(253) 735-1991
(253) 735-8837
Mailing address
1268 E MAIN ST, SUITE 1, AUBURN, WA 98002-5748
(253) 735-1991
(253) 735-8837
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
602300908
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7117252
—
WA
Enumeration date
08/29/2006
Last updated
07/17/2014
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