Healthcare Provider Details

I. General information

NPI: 1306973235
Provider Name (Legal Business Name): DIGESTIVE DISEASE & ENDOSCOPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3261 NW MOUNT VINTAGE WAY STE 221
SILVERDALE WA
98383-6039
US

IV. Provider business mailing address

3261 NW MOUNT VINTAGE WAY STE 221
SILVERDALE WA
98383-6039
US

V. Phone/Fax

Practice location:
  • Phone: 360-792-9118
  • Fax: 360-918-9726
Mailing address:
  • Phone: 360-479-1952
  • Fax: 360-918-9726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberASF.FS.60287214
License Number StateWA

VIII. Authorized Official

Name: JUSTIN SAETRUM
Title or Position: CEO
Credential:
Phone: 360-479-1952