Provider Demographics
NPI:1285850461
Name:BRAIN MATTERS IMAGING CENTERS
Entity type:Organization
Organization Name:BRAIN MATTERS IMAGING CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PRESIDENT, CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-941-6428
Mailing Address - Street 1:1015 8TH AVE NORTH
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3504
Mailing Address - Country:US
Mailing Address - Phone:206-287-3900
Mailing Address - Fax:206-287-3905
Practice Address - Street 1:1015 8TH AVE NORTH
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-3504
Practice Address - Country:US
Practice Address - Phone:206-287-3900
Practice Address - Fax:206-287-3905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology