Provider Demographics
NPI:1417600271
Name:PERFECTION ULTRASOUND
Entity Type:Organization
Organization Name:PERFECTION ULTRASOUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED SONOGRAPHER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:ARDMS
Authorized Official - Phone:509-591-8528
Mailing Address - Street 1:5801 W 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2187
Mailing Address - Country:US
Mailing Address - Phone:509-591-8528
Mailing Address - Fax:
Practice Address - Street 1:124 W KENNEWICK AVE STE 8
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3830
Practice Address - Country:US
Practice Address - Phone:509-591-8528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No251K00000XAgenciesPublic Health or Welfare
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA604819518OtherREGISTERED SONOGRAPHER ARDMS
WA604819518Medicaid