Provider Demographics
NPI:1013907955
Name:NORTHWEST RADIOLOGISTS INC PS
Entity Type:Organization
Organization Name:NORTHWEST RADIOLOGISTS INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUDZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-733-0430
Mailing Address - Street 1:2930 SQUALICUM PKWY
Mailing Address - Street 2:SUITE B10
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1854
Mailing Address - Country:US
Mailing Address - Phone:360-733-0430
Mailing Address - Fax:360-733-0438
Practice Address - Street 1:2901 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1851
Practice Address - Country:US
Practice Address - Phone:360-734-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-23
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6000139222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7824808Medicaid
001447200Medicare ID - Type UnspecifiedGROUP PROV#