Provider Demographics
NPI:1144288226
Name:SPOKANE ADVANCED IMAGING INSTITUTE LLC
Entity type:Organization
Organization Name:SPOKANE ADVANCED IMAGING INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:HALLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-637-3378
Mailing Address - Street 1:11100 NE 8TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4465
Mailing Address - Country:US
Mailing Address - Phone:425-637-2991
Mailing Address - Fax:425-637-7535
Practice Address - Street 1:800 W 5TH AVE
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2803
Practice Address - Country:US
Practice Address - Phone:509-473-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2085R0202X
WA261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology