Provider Demographics
NPI:1477534246
Name:AUBURN IMAGING PARTNERS LLC
Entity Type:Organization
Organization Name:AUBURN IMAGING PARTNERS LLC
Other - Org Name:AUBURN DIAGNOSTIC IMAGING SERVICES MERRITT BUILDING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:LUND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-661-1700
Mailing Address - Street 1:PO BOX 25490
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98093-2490
Mailing Address - Country:US
Mailing Address - Phone:253-661-1700
Mailing Address - Fax:253-661-4565
Practice Address - Street 1:125 3RD ST NE
Practice Address - Street 2:#300
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4035
Practice Address - Country:US
Practice Address - Phone:253-886-5307
Practice Address - Fax:253-886-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7127343Medicaid
WA8854128Medicare PIN