Organization
PORTLAND MEDICAL IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD KIZZIAR (ADMINISTRATIVE DIRECTOR)
(503) 215-8900
Entity
Organization
Contact information
Practice address
10538 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 215-8900
(503) 215-8920
Mailing address
10538 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 215-8900
(503) 215-8920
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
2085N0700X
Neuroradiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
04/10/2006
Last updated
10/01/2007
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