Patricia A. Mizutani, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD00036015 Issued in WA

Practice address

4816A NE Thurston Way
Vancouver, WA 98662

Phone

(360) 254-4914

Fax

(360) 449-4961

NPI assigned

Jun 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advanced Medical Imaging Center LLC

  • Diagnostic Radiology Physician
  • Vancouver, WA
  • NPI 1114008737
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1881698710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 NE 66TH AVE.",
            "address_2": "SUITE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-254-4914",
            "fax_number": "360-449-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816A NE THURSTON WAY",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98662",
            "telephone_number": "360-254-4914",
            "fax_number": "360-449-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZUTANI",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00036015",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD17268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie C Mittelstaedt, MD, MPH
• Julie Mittura, RD
• Cristina Miu, MASSAGE THERAPIST
• Nyakuoth Miyoang
• Lauren Mizrahi
• Sharon Moak, LMP
• Kevin Moar
• Mobile Chiropractic North West , Inc.
• Mobile Healthcare Providers Northwest
• Mobilehealthcareprovidersnorthwest

• Diagnostic Radiology Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.