Basic Information
| Provider Information | |||||||||
| NPI: | 1467079434 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EXIGES IMAGING, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25115 SW PARKWAY AVE STE B | ||||||||
| Address2: | |||||||||
| City: | WILSONVILLE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970708891 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035703405 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25115 SW PARKWAY AVE STE B | ||||||||
| Address2: | |||||||||
| City: | WILSONVILLE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970708891 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035703405 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2020 | ||||||||
| LastUpdateDate: | 08/25/2022 | ||||||||
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| AuthorizedOfficialLastName: | MCDANIEL | ||||||||
| AuthorizedOfficialFirstName: | RICK | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5037054962 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 335V00000X | Y | Suppliers | Portable X-Ray Supplier |
No ID Information.