Puyallup Open Imaging LLC

Primary specialty

Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X

Legal business name

PUYALLUP OPEN IMAGING LLC

Practice address

12623 Meridian E
Ste A1
Puyallup, WA 98373-3469

Phone

(253) 864-6531

Fax

(253) 864-6539

NPI assigned

Nov 9, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Donald A Zimmer

Title

Managing Partner

Phone

(877) 630-9804

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801877618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2784 12TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973023159",
            "telephone_number": "877-630-9804",
            "fax_number": "503-586-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12623 MERIDIAN E",
            "address_2": "STE A1",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733469",
            "telephone_number": "253-864-6531",
            "fax_number": "253-864-6539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUYALLUP OPEN IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZIMMER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "877-630-9804",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2471M1202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7114465",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Magnetic Resonance Imaging Radiologic Technologist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Magnetic Resonance Imaging 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.