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NPI Code Detail

MEDICARE: ASSOCIATED SURGEONS OF WASHINGTON

MEDICARE: ASSOCIATED SURGEONS OF WASHINGTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistWA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558349902
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASSOCIATED SURGEONS OF WASHINGTON
Provider Business Mailing Address
First Line : 1720 COOKS HILL RD
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-9071
Country : US
Telephone Number : 360-736-1195
Fax Number : 360-736-4952
Provider Business Practice Location Address
First Line : 1720 COOKS HILL RD
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-9071
Country : US
Telephone Number : 360-736-1195
Fax Number : 360-736-4952
Authorized Official
Title or Position : MD
Name : ATUL THAKKER
Credential : M.D.
Telephone Number : 360-736-1195
Provider Enumeration Date : 01/05/2006
Last Update Date : 12/13/2007

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Directions to “ASSOCIATED SURGEONS OF WASHINGTON ” Practice Location

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