Healthcare Provider Details

I. General information

NPI: 1427108398
Provider Name (Legal Business Name): SOUTH SOUND ANESTHESIA ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 CAPITAL MALL DR SW STE B
OLYMPIA WA
98502-8654
US

IV. Provider business mailing address

PO BOX 94525
SEATTLE WA
98124-6825
US

V. Phone/Fax

Practice location:
  • Phone: 360-709-6230
  • Fax:
Mailing address:
  • Phone: 425-407-1500
  • Fax: 425-407-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD00026484
License Number StateWA

VIII. Authorized Official

Name: DR. GARY DOOLITTLE
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 360-709-6230