Organization
NORTHWEST MOBILE IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREN GLASSMAN (PRESIDENT)
(503) 646-7777
Entity
Organization
Contact information
Practice address
6140 SW ARCTIC DR, BEAVERTON, OR 97005-9448
(503) 646-7777
Mailing address
PO BOX 66500, PORTLAND, OR 97290
(503) 657-8663
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932156981
NPI NUMBER
ID
01
—
1932156981
NPI NUMBER
OR
01
—
1932156981
NPI NUMBER
WA
05
—
7125305
—
WA
01
—
7131568
MEDICAID TECH ONLY
WA
01
—
P00219865
MEDICARE RAILROAD
—
Enumeration date
05/27/2006
Last updated
11/15/2007
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