Provider Demographics
NPI:1124046057
Name:RADIOLOGY CONSULTANTS OF WASHINGTON, INC., P.S.
Entity Type:Organization
Organization Name:RADIOLOGY CONSULTANTS OF WASHINGTON, INC., P.S.
Other - Org Name:RAYUS RADIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MACAULAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-821-3472
Mailing Address - Street 1:PO BOX 94624
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-6924
Mailing Address - Country:US
Mailing Address - Phone:425-821-3472
Mailing Address - Fax:425-820-4115
Practice Address - Street 1:12112 115TH AVE NE STE B
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-6958
Practice Address - Country:US
Practice Address - Phone:425-821-3472
Practice Address - Fax:425-820-4115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7044795Medicaid
WA7044795Medicaid