Out Reach Mobile Imaging

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

19683 Issued in WA

Legal business name

OUT REACH MOBILE IMAGING

Practice address

11012 Canyon Rd E
Ste 8
Puyallup, WA 98373-4200

Phone

(253) 921-6613

Fax

(253) 435-1933

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Theresa M Trebilcock, RDMS, RDCS

Title

Owner

Phone

(253) 921-6613

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255354270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11012 CANYON RD E",
            "address_2": "STE 8",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734200",
            "telephone_number": "253-921-6613",
            "fax_number": "253-435-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11012 CANYON RD E",
            "address_2": "STE 8",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734200",
            "telephone_number": "253-921-6613",
            "fax_number": "253-435-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUT REACH MOBILE IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TREBILCOCK",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-921-6613",
        "authorized_official_credential": "RDMS, RDCS"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": "WA",
            "license": "19683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth B Ost, MD
• Lynn C Ostenson, M.D.
• Amy Elizabeth Ottinger, LMP
• Vincent Peter Otundo
• Lyne Marie Ouellet, M.D.
• Katherine Marie Overbeck, ARNP
• Carol Overcash
• Anneka Overturf, RN, IBCLC
• Miranda Lindsay Owen
• Ashlee Rose Owens

• Sonography Radiologic Technologist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Sonography Radiologic Technologist 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.