Organization Name: | OLYMPIA OPEN MRI LLC |
NPI Number: | 1073573820 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN MICHAEL GOLDEN (MANAGING MEMBER) |
Mailing Address: | 669 Woodland Square Loop Se Ste D Lacey |
State: | WA US |
Postal Code: | 985031038 |
Phone Number: | 3604139393 |
Fax Number: | 3604139365 |
NPI Enumeration Date: | 03/24/2006 |
NPI Last Update Date: | 10/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |