Provider Demographics
NPI:1750611141
Name:NW MOBILE RADIOLOGY
Entity type:Organization
Organization Name:NW MOBILE RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-224-2030
Mailing Address - Street 1:25117 SW PARKWAY AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9697
Mailing Address - Country:US
Mailing Address - Phone:877-786-9729
Mailing Address - Fax:503-646-7036
Practice Address - Street 1:6140 SW ARCTIC DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-9448
Practice Address - Country:US
Practice Address - Phone:877-786-9729
Practice Address - Fax:503-646-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile