Provascular Diagnostic and Imaging PLLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

PROVASCULAR DIAGNOSTIC AND IMAGING PLLC

Practice address

202 N Division St
Suite 200
Auburn, WA 98001-4939

Phone

(253) 735-4341

NPI assigned

May 21, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dennis Su, MD

Title

Owner

Phone

(253) 735-4341

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1003252776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N DIVISION ST",
            "address_2": "SUITE 200",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014939",
            "telephone_number": "253-735-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N DIVISION ST",
            "address_2": "SUITE 200",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014939",
            "telephone_number": "253-735-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVASCULAR DIAGNOSTIC AND IMAGING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "SU",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-735-4341",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Auburn, WA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.