NPIMap

Organization Active NPI

Columbia Imaging Group, PS

  • Diagnostic Radiology Physician
  • Vancouver, WA
National Provider Identifier
1730140260
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
COLUMBIA IMAGING GROUP, PS
Practice address
400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone
(360) 514-2161
Fax
(360) 514-2663
NPI assigned
Apr 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
William Brinkman, MD
Title
President
Phone
(360) 892-9664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Mailing address

13215 SE Mill Plain Blvd
Ste C8-901
Vancouver, WA 98684-6963
Phone (360) 892-9664

Other identifiers 4

IdentifierTypeStateIssuer
7124662MedicaidWA
DC1642OtherWARR MEDICARE
277919MedicaidOR
807238800MedicaidID

National Provider Directory

National Provider Directory

Locations

13215 SE Mill Plain Blvd
Ste C8901
Vancouver, WA 98684

200 NE Mother Joseph Pl
Ste 300
Vancouver, WA 98664
Phone (360) 256-4060

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1730140260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13215 SE MILL PLAIN BLVD",
            "address_2": "STE C8-901",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846963",
            "telephone_number": "360-892-9664",
            "fax_number": "360-892-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-514-2161",
            "fax_number": "360-514-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA IMAGING GROUP, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-01",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "BRINKMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-892-9664",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7124662",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DC1642",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277919",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807238800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.