NPIMap

Organization Active NPI

Tellica Imaging - Washington LLC

  • Radiology Clinic/Center
  • Tacoma, WA
National Provider Identifier
1346093150
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
TELLICA IMAGING - WASHINGTON LLC
Practice address
2941 S 38TH St Ste E
Tacoma, WA 98409-5647
Phone
(253) 534-8689
Fax
(253) 617-1296
NPI assigned
Apr 10, 2024
Last updated
Jan 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Authorized official

Name
Brad Isaacson, PHD
Title
President
Phone
(801) 442-6000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

2941 S 38TH St Ste E
Tacoma, WA 98409-5647

Mailing address

36 S State St
Salt Lake City, UT 84111-1401

Other practice location 1

4207 Wheaton Way Ste Ab
Bremerton, WA 98310-3605
Phone (360) 824-3570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260123001076 WA Part B Supplier - Clinic/Group Practice 0648757393 Receives reassigned benefits from 88 practitioners
1 other NPI on this enrollment
Practice locations: Auburn, WA; Bremerton, WA; Tacoma, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2329318Tellica Imaging - Washington LLC2941 S 38TH Street, Ste E, Tacoma, WA 98409Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Tellica Imaging - Washington LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4207 Wheaton Way
Ste Ab
Bremerton, WA 98310
Phone (360) 824-3570

2921 S 38th St
Tacoma, WA 98409

2941 S 38th St
Ste E
Tacoma, WA 98409
Phone (253) 534-8689

Practitioners & affiliated clinicians

Practitioners 87

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1346093150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 S STATE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 S 38TH ST STE E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984095647",
            "telephone_number": "253-534-8689",
            "fax_number": "253-617-1296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4207 Wheaton Way Ste Ab",
            "address_purpose": "LOCATION",
            "city": "Bremerton",
            "state": "WA",
            "postal_code": "983103605",
            "country_code": "US",
            "telephone_number": "360-824-3570",
            "fax_number": "253-617-1296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TELLICA IMAGING - WASHINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "ISAACSON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-442-6000",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.