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TELLICA IMAGING - WASHINGTON LLC
NPI 1215887401
Clinic/Center - Radiology in Auburn, WA

Active since January 29, 2026CLIA 50D2329104 · Waiver
421 EAST MAIN STREET, AUBURN, WA 98002(253) 204-2530(253) 617-1296 Get Directions Write a Review

NPPES record last updated: January 29, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tellica Imaging - Washington Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TELLICA IMAGING - WASHINGTON LLC (NPI 1215887401) is a healthcare organization registered as a radiology in Auburn, Washington and active in the NPI registry since January 2026. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Brad Isaacson, President, as its authorized official.

NPPES Registry Identity

NPI1215887401
Entity TypeOrganization
Primary Taxonomy261QR0200X
Legal Business NameTELLICA IMAGING - WASHINGTON LLC
Location Address421 EAST MAIN STREETAuburn, WA 98002
Mailing Address36 S State StSalt Lake City, UT 84111-1401
Phone(253) 204-2530
Fax(253) 617-1296
Organization SubpartNo
Authorized OfficialBrad IsaacsonPresident · (801) 442-6000
Enumeration DateJanuary 29, 2026
NPPES CertifiedJanuary 26, 2026
✔ NPI 1215887401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X
421 EAST MAIN STREET, Auburn, WA 98002
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tellica Imaging - Washington Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

88

Medicare enrollment records show 88 clinicians reassign Medicare billing to Tellica Imaging - Washington LLC, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Diagnostic Radiology82
Nurse Practitioner5
Interventional Radiology1

Nearest to this location (20)

See all 88
Rae Iams, ARNP
Nurse Practitioner
NPI 1215369749
11216 SUNRISE BLVD E STE 3-207
Puyallup, WA 98374
(253) 770-3700
✔ PECOS15 mi
Jerome Bouie, RN,BSN.CCRN
Nurse Practitioner
NPI 1639523871
MADIGAN ARMY MEDICAL CTR 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
Tacoma, WA 98431
(512) 689-5719
✔ PECOS21 mi
Jodi Kirk, FNP
Nurse Practitioner
NPI 1164973558
1623 N 1ST ST
Hermiston, OR 97838
(458) 300-9014
✔ PECOS✔ Accepts Medicare172 mi
Spencer Robertson, M.D.
Diagnostic Radiology
NPI 1225172661
1501 HILAND AVE
Burley, ID 83318
(208) 678-4444
✔ PECOS✔ Accepts Medicare529 mi
Brett Larsen, MD
Diagnostic Radiology
NPI 1750744421
3903 HARRISON BLVD 100
Ogden, UT 84403
(801) 387-7466
✔ PECOS✔ Accepts Medicare661 mi
Travis Mckenzie, D.O.
Diagnostic Radiology
NPI 1386900595
4401 HARRISON BLVD
Ogden, UT 84403
(801) 387-2800
✔ PECOS✔ Accepts Medicare661 mi
Kathryn Morton, MD
Diagnostic Radiology
NPI 1891885406
50 N MEDICAL DR
Salt Lake City, UT 84132
(801) 581-2121
✔ PECOS✔ Accepts Medicare685 mi
Daniel Sommers, M.D.
Diagnostic Radiology
NPI 1720191216
50 N MEDICAL DR
Salt Lake City, UT 84132
(801) 581-2121
✔ PECOS✔ Accepts Medicare685 mi
William Bireley, M.D.
Diagnostic Radiology
NPI 1699929521
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
(801) 487-0451
✔ PECOS✔ Accepts Medicare685 mi
Mark Ebert, MD
Diagnostic Radiology
NPI 1609901610
100 N MARIO CAPECCHI DR DEPT OF MEDICAL IMAGING
Salt Lake City, UT 84113
(801) 875-1586
✔ PECOS✔ Accepts Medicare685 mi
Michael Katz, MD
Diagnostic Radiology
NPI 1861463390
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
(801) 487-0451
✔ PECOS✔ Accepts Medicare685 mi
Jeffrey Prince, MD
Diagnostic Radiology
NPI 1013027085
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
(801) 487-0451
✔ PECOS✔ Accepts Medicare685 mi
Jonathan Wood, MD
Diagnostic Radiology
NPI 1255567947
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
(801) 487-0451
✔ PECOS✔ Accepts Medicare685 mi
Patrick Frias, MD
Diagnostic Radiology
NPI 1437655255
30 N 1900 E RM 1A071
Salt Lake City, UT 84132
(801) 581-2868
✔ PECOS✔ Accepts Medicare685 mi
Ryan Hirschi, MD
Diagnostic Radiology
NPI 1285297861
HELIX: 30 N MARIO CAPECCHI RM 2S100
Salt Lake City, UT 84112
(801) 581-2121
✔ PECOS✔ Accepts Medicare685 mi
Clifton Hartwell, MD
Diagnostic Radiology
NPI 1386104297
30 N 1900 E RM 1A071
Salt Lake City, UT 84132
(801) 581-2868
✔ PECOS✔ Accepts Medicare686 mi
Benjamin Romney, M.D.
Diagnostic Radiology
NPI 1780815027
DEPARTMENT OF RADIOLOGY 30 NORTH 1900 EAST #1A071
Salt Lake City, UT 84132
(801) 581-7553
✔ PECOS✔ Accepts Medicare686 mi
Rohit Ram, MD
Interventional Radiology
NPI 1235493693
5295 S COMMERCE DR STE 550
Murray, UT 84107
(801) 313-4110
✔ PECOS✔ Accepts Medicare689 mi
Meghan Fashjian, ACNP-BC
Nurse Practitioner
NPI 1104153626
171 ASHLEY AVE
Charleston, SC 29425
(843) 792-1414
✔ PECOS✔ Accepts Medicare2,418 mi
Francisca Salazar, ARNP
Nurse Practitioner
NPI 1477975282
580 W 8TH ST UFJAX - DEPT. OF NEUROSURGERY
Jacksonville, FL 32209
(904) 383-1022
✔ PECOS✔ Accepts Medicare2,444 mi
See all 88 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2329104

Tellica Imaging - Washington LLC · Auburn, WA
Active · expires Apr 4, 2028
CLIA Number50D2329104
Laboratory TypeDiagnostic Imaging Fac
Certificate Effective DateAugust 21, 2025
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAustin Thornhill
Laboratory Phone(253) 534-8688
Laboratory LocationTellica Imaging - Washington LLC421 E Main Street, Auburn, WA 98002
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tellica Imaging - Washington LLC's NPI number?

The NPI number for Tellica Imaging - Washington LLC is 1215887401. It was assigned to this organization in the NPPES registry on January 29, 2026.

Where is Tellica Imaging - Washington LLC located?

Tellica Imaging - Washington LLC is located at 421 East Main Street, Auburn, WA 98002. The listed phone number is (253) 204-2530.

What is Tellica Imaging - Washington LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, with taxonomy code 261QR0200X.

Is Tellica Imaging - Washington LLC enrolled in Medicare?

Yes. Tellica Imaging - Washington LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tellica Imaging - Washington LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 88 clinicians in 3 Medicare specialties reassign their Medicare billing to Tellica Imaging - Washington LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (82), Nurse Practitioner (5) and Interventional Radiology (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Tellica Imaging - Washington LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2329104) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tellica Imaging - Washington LLC was last updated on January 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.