NPIMap

Organization Active NPI

Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance

  • Radiology Clinic/Center
  • Bonney Lake, WA
National Provider Identifier
1760636930
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
602760002
Legal business name
MEDICAL IMAGING NORTHWEST - GOOD SAMARITAN HOSPITAL IMAGING ALLIANCE
Practice address
21110 Sr 410 E
#110
Bonney Lake, WA 98391-8457
Phone
(253) 841-4353
Fax
(253) 583-8630
NPI assigned
Nov 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Authorized official

Name
Dr. Douglas P Seiler, MDNPI 1518076280
Title
President
Phone
(253) 761-4200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 602760002 Primary

Addresses

Primary practice location

21110 Sr 410 E
#110
Bonney Lake, WA 98391-8457

Mailing address

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone (253) 761-4200

National Provider Directory

National Provider Directory
Tax ID family
Diagnostic Medical Imaging3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

21110 Sr 410 E
#110
Bonney Lake, WA 98391

222 15th Ave SE
Ste 220
Puyallup, WA 98372

1450 5th St SE
Ste 4600
Puyallup, WA 98372

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

Practitioners & affiliated clinicians

Practitioners 52

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

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544745600000",
    "number": "1760636930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200",
            "fax_number": "253-583-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21110 SR 410 E",
            "address_2": "#110",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918457",
            "telephone_number": "253-841-4353",
            "fax_number": "253-583-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL IMAGING NORTHWEST - GOOD SAMARITAN HOSPITAL IMAGING ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2018-12-14",
        "status": "A",
        "authorized_official_last_name": "SEILER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-761-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": "602760002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.