Provider Demographics
NPI:1669929840
Name:ARMSTRONG, TRAVIS (RDMS)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 N GOVERNMENT WAY
Mailing Address - Street 2:SUITE J
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3658
Mailing Address - Country:US
Mailing Address - Phone:208-261-2520
Mailing Address - Fax:
Practice Address - Street 1:2201 N GOVERNMENT WAY
Practice Address - Street 2:SUITE J
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-3658
Practice Address - Country:US
Practice Address - Phone:208-261-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524762471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography