Provider Demographics
NPI:1215990924
Name:INHEALTH IMAGING, LLC
Entity type:Organization
Organization Name:INHEALTH IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:HENNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-598-3141
Mailing Address - Street 1:PO BOX 1399
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-0139
Mailing Address - Country:US
Mailing Address - Phone:360-598-3141
Mailing Address - Fax:
Practice Address - Street 1:20700 BOND RD NE
Practice Address - Street 2:BLDG B
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-9099
Practice Address - Country:US
Practice Address - Phone:360-598-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025231247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7114325Medicaid
WA7114325Medicaid
WAGAB28653Medicare ID - Type Unspecified