Provider Demographics
NPI:1497914790
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:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CALIXTO
Authorized Official - Middle Name:T
Authorized Official - Last Name:DIMAS
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:952-542-8553
Mailing Address - Fax:952-513-6880
Practice Address - Street 1:3131 NASSAU ST
Practice Address - Street 2:SUITE 102
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4137
Practice Address - Country:US
Practice Address - Phone:425-740-5000
Practice Address - Fax:425-740-5010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7044795Medicaid
WAG8857320Medicare PIN