Northwest Radiology Group LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NORTHWEST RADIOLOGY GROUP LLC

Practice address

500 Lilly Rd NE
Suite 160
Olympia, WA 98506-5195

Phone

(360) 413-8307

Fax

(360) 413-8805

NPI assigned

Feb 12, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nelson R Goehle

Title

Owner Ceo

Phone

(360) 413-8301

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194867887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LILLY RD NE",
            "address_2": "SUITE 160",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065195",
            "telephone_number": "360-413-8307",
            "fax_number": "360-413-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LILLY RD NE",
            "address_2": "SUITE 160",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065195",
            "telephone_number": "360-413-8307",
            "fax_number": "360-413-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST RADIOLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOEHLE",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "360-413-8301"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Olympia, WA
• Providers in Olympia, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.