VANTAGE RADIOLOGY & DIAGNOSTIC SERVICES, A PROFESSIONAL SERVICES CORP (NPI# 1245230598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245230598 |
| Entity Type | Organization |
| Organization Name | VANTAGE RADIOLOGY & DIAGNOSTIC SERVICES, A PROFESSIONAL SERVICES CORP |
| Other Organization Name | VALLEY MEDICAL CENTER |
| Practice Address |
400 S 43rd St Renton WA 98055 |
| Mailing Address |
Po Box 26730 Federal Way WA 98093-3730 |
| Practice Telephone | 4252515183 |
| Mailing Telephone | 2536611700 |
| Mailing Fax Number | 2536614565 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2020-05-08 |
| Authorized Official Name | BETH L. WILLIAMS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2536611700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
========= | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | MEDICARE PROVIDER # | G000159700 | 01 |
| Other Name | Type Code |
|---|---|
| VALLEY MEDICAL CENTER | Former Legal Business Name - Organization |
| Street Address |
400 S 43RD ST |
| City | RENTON |
| State | WA |
| Zip Code | 98055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780681569 | Minsoo Kang | Internal Medicine | 400 S 43rd St, Renton, WA 98055 | 2005-07-07 |
| 1700490760 | Toni Anne Wolcott | Registered Nurse | 400 S 43rd St, Renton, WA 98055 | 2020-09-06 |
| 1770107484 | Richmond Li | Registered Nurse | 400 S 43rd St, Renton, WA 98055-5714 | 2020-05-29 |
| 1144840711 | Brendan Wesley-smith | Registered Nurse | 400 S 43rd St, Renton, WA 98055-5714 | 2020-04-23 |
| 1205460359 | Yingying Lu | Registered Nurse | 400 S 43rd St, Renton, WA 98055-5714 | 2020-02-27 |
| 1508404955 | Hannah Rae Humphrey | Speech-Language Pathologist | 400 S 43rd St, Renton, WA 98055-5714 | 2019-12-17 |
| 1881232247 | Jennifer Susan Katz | Physical Therapist | 400 S 43rd St, Renton, WA 98055-5714 | 2019-12-17 |
| 1760029714 | Selam Estefanos | Registered Nurse | 400 S 43rd St, Renton, WA 98055-5714 | 2019-12-09 |
| 1407493133 | Alba Sari | Registered Nurse | 400 S 43rd St, Renton, WA 98055-5714 | 2019-12-02 |
| 1336784131 | Julia Lysyuk | Nurse Anesthetist, Certified Registered | 400 S 43rd St, Renton, WA 98055-5714 | 2019-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306189188 | Harsha Nalluri | Radiology | 400 S 43rd St, Renton, WA 98055-5714 | 2013-03-31 |
| 1215918081 | Imaging Partners At Valley LLC | Radiology | 400 S 43rd St, Olympic Building, Renton, WA 98055-5714 | 2005-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790325710 | Proliance Surgeons, Inc., P.s. | Radiology | 1101 Madison St Ste 580, Seattle, WA 98104-4305 | 2020-01-07 |
| 1447711544 | Ashkan Jonathan Ahmadian | Radiology | 1959 Ne Pacific Street Radiology Department Rr 210, Seattle, WA 98195-1019 | 2019-03-29 |
| 1639653017 | Radia Imaging Center Holdings LLC | Radiology | 1229 Madison St Ste 900, Seattle, WA 98104-1391 | 2018-09-20 |
| 1427546597 | Kiet Van Vo | Radiology | 1959 Ne Pacific St # 357115, Seattle, WA 98195-0001 | 2018-04-24 |
| 1730605965 | Bellingham Advanced Medical Imaging LLC | Radiology | 1344 King St Ste 101, Bellingham, WA 98229-6215 | 2017-08-18 |
| 1184140477 | Proliance Surgeons, Inc., P.s. | Radiology | 6808 220th St Sw Ste 105, Mountlake Terrace, WA 98043-2187 | 2017-08-17 |
| 1003367863 | Providence Health & Services Washington | Radiology | 4800 College St Se Ste E, Lacey, WA 98503-4389 | 2016-10-17 |
| 1861846057 | Ethan Hua | Radiology | Radiology Department Rr 210 1959 Ne Pacific, Seattle, WA 98195-0001 | 2016-04-14 |
| 1437537354 | Mahmood Albahhar | Radiology | 4245 Roosevelt Way Ne Box 354755, University of Washington Medical Center, Seattle, WA 98105 | 2015-05-12 |
| 1336533991 | Keegan Hovis | Radiology | 1959 Ne Pacific Street Radiology Department, Seattle, WA 98195-3358 | 2015-03-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.