SOUTH SOUND RADIOLOGY ABERDEEN LLC (NPI# 1194819086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194819086 |
| Entity Type | Organization |
| Organization Name | SOUTH SOUND RADIOLOGY ABERDEEN LLC |
| Other Organization Name | GRAYS HARBOR IMAGING LLC |
| Practice Address |
1108 Basich Blvd Aberdeen WA 98520-1066 |
| Practice Telephone | 3605330400 |
| Practice Fax Number | 3605335633 |
| Mailing Telephone | 3605330400 |
| Mailing Fax Number | 3605335633 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2013-11-13 |
| Authorized Official Name | TREMONT VINCENT PARRINO (CO-PRESIDENT) |
| Authorized Official Telephone | 3604934600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LABOR & INDUSTRIES INDUSTRIAL INSURANCE GROUP # | 0223967 | 01 |
| Other Name | Type Code |
|---|---|
| Grays Harbor Imaging LLC | Doing Business As Name - Organization |
| Street Address |
1108 BASICH BLVD |
| City | ABERDEEN |
| State | WA |
| Zip Code | 98520-1066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861429953 | Ryan Shurtliff Farrer | Radiology | 1108 Basich Blvd, Aberdeen, Aberdeen, WA 98520-1066 | 2006-06-26 |
| 1104045889 | Joseph Wayne Stengel | Radiology | 1108 Basich Blvd, Aberdeen, WA 98520-1066 | 2007-04-24 |
| 1619001088 | Grays Harbor Imaging LLC | Specialist | 1108 Basich Blvd, Aberdeen, WA 98520-1066 | 2007-03-15 |
| 1639203649 | Harbor Radiologists, P.s. | Clinic/Center | 1108 Basich Blvd, Aberdeen, WA 98520-1066 | 2007-03-14 |
| 1548393424 | Loren Earnest Laybourn | Radiology | 1108 Basich Blvd, Aberdeen, WA 98520-1066 | 2007-03-13 |
| 1730269366 | Thomas D Rowley | Radiology | 1108 Basich Blvd, Harbor Radiologists Ps, Aberdeen, WA 98520-1066 | 2006-10-17 |
| 1730272659 | Michael E Cagan | Radiology | 1108 Basich Blvd, Aberdeen, WA 98520-1066 | 2006-10-02 |
| 1447343363 | Dennis M Oconnell | Radiology | 1108 Basich Blvd, Aberdeen, WA 98520-1066 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740755354 | Wchs, Inc. | Clinic/Center | 516 East 1st Street, Aberdeen, WA 98520 | 2018-10-10 |
| 1518454180 | Katie Cutshaw | Counselor | 1700 Cherry Street, Suite C, Aberdeen, WA 98520 | 2018-04-18 |
| 1629587738 | Robert Williams | Counselor | Catholic Community Services, 403 West State Street, Suite 206, Aberdeen, WA 98520 | 2017-09-21 |
| 1174032296 | Amy D Tyler | Peer Specialist | 403 W State Street, Ste 206, Aberdeen, WA 98520 | 2017-09-20 |
| 1073032819 | Amanda Leona Franklin | Counselor | 2700 Simpson Ave, Suite 101, Aberdeen, WA 98520 | 2017-09-13 |
| 1184141152 | Chrystal Lynn Beckley | Counselor | 2700 Simpson Avenue Suite 101, Aberdeen, WA 98520 | 2017-08-29 |
| 1285158923 | Josh Butler | Technician/Technologist | 1718 Sumner Ave, Aberdeen, WA 98520 | 2017-08-02 |
| 1386165553 | Melvin Taylor | Counselor | 311 South I Street, Aberdeen, WA 98520 | 2017-06-28 |
| 1164870267 | Kelly Knittle | Counselor | 4820 She-nah-num Dr. Se, Olympia, WA 98520 | 2016-05-31 |
| 1437570249 | Aberdeen Therapy Works | Occupational Therapist | 100 S. I Street, Suite 205, Aberdeen, WA 98520 | 2013-12-20 |
| Find all providers in zip 98520 | ||||
| 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 |
|---|---|---|---|---|
| 1366846073 | Pacific Coast Radiology Associates Pllc | Radiology | 205 9th Ave, Aberdeen, WA 98520-1336 | 2014-10-09 |
| 1861429953 | Ryan Shurtliff Farrer | Radiology | 1108 Basich Blvd, Aberdeen, Aberdeen, WA 98520-1066 | 2006-06-26 |
| 1083693303 | Jack Barnet Vonk | Radiology | 24-2nd Ave Sw, Aberdeen, SD 57401 | 2006-01-13 |
| 1437425733 | Ryan Joseph Gnesda | Radiology | 305 S State St, Aberdeen, SD 57401-4527 | 2012-03-30 |
| 1083990261 | Coastal Specialty Imaging | Radiology | 1006 N H St, 5th Floor, Aberdeen, WA 98520-2521 | 2011-11-01 |
| 1164705794 | Loren E. Laybourn, Md Ps | Radiology | 100 S I St, Ste. 103, Aberdeen, WA 98520-6502 | 2011-09-20 |
| 1225266562 | Brian J Rau | Radiology | 305 S State St, Aberdeen, SD 57401-4527 | 2009-06-25 |
| 1285824011 | Balasubramanya Kolar | Radiology | 3015 3rd Ave Se, Aberdeen, SD 57401-5418 | 2007-07-27 |
| 1104045889 | Joseph Wayne Stengel | Radiology | 1108 Basich Blvd, Aberdeen, WA 98520-1066 | 2007-04-24 |
| 1942425277 | Daniel Robert Fritz | Radiology | 305 S State St, Aberdeen, SD 57401-4527 | 2007-04-13 |
| Find all providers in ABERDEEN | ||||
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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.