Healthcare Provider Details

I. General information

NPI: 1457982308
Provider Name (Legal Business Name): SALISH SEDATION SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 SQUALICUM PKWY STE 202
BELLINGHAM WA
98225-1854
US

IV. Provider business mailing address

PO BOX 24091
SEATTLE WA
98124-0091
US

V. Phone/Fax

Practice location:
  • Phone: 360-734-1420
  • Fax:
Mailing address:
  • Phone: 202-780-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN RAMOS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 202-780-1700