Provider Demographics
NPI:1598095838
Name:PACIFIC MEDICAL IMAGING, INC.
Entity Type:Organization
Organization Name:PACIFIC MEDICAL IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-730-0811
Mailing Address - Street 1:12180 SE GREINER LN
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-6366
Mailing Address - Country:US
Mailing Address - Phone:503-762-2842
Mailing Address - Fax:503-719-7956
Practice Address - Street 1:12180 SE GREINER LN
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-6366
Practice Address - Country:US
Practice Address - Phone:503-762-2842
Practice Address - Fax:503-719-7956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile