Diagnostic Radiologists Pc

LBN: Diagnostic Radiologists Pc
Diagnostic Radiologists Pc is an health care organization with primary practice located at 10123 Se Market , Portland OR 97216. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as the primary health care specialty. Diagnostic Radiologists Pc can be contacted via phone (503) 251-6132, or through Peterson, Jed Russell via phone (503) 251-6132.

Contact Information

Primary practice address
10123 Se Market Portland OR 97216
Phone: (503) 251-6132
Fax: (503) 251-6136
Website:
Map and Directions
Authorized official contact:
Name: Peterson, Jed Russell Doctor of Medicine (MD)
Phone: (503) 251-6132

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X

Profile Details

NPI number 1053368563
LBN Legal business name Diagnostic Radiologists Pc
DBA Doing business as
Authorized official Peterson, Jed Russell Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 28th, 2006
Last updated May 20th, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053368563 NPPES
Hawaii MEDICAID H110076
Hawaii MEDICAID 7805609
Hawaii MEDICAID 064972

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