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General NPI Number Information
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NPI Number | 1215082557
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Entity Type | Organization
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Legal Business Name | AUBURN OUTPATIENT SURGERY CENTER, LLC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 208 17TH AVE SE SUITE 202
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City | PUYALLUP
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State | WA
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Zip | 98372-4515
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Country | US
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Telephone | 360-825-4466
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Fax | 360-825-2064
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Provider Business Mailing Address
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Address Line | 1427 JEFFERSON AVE, SUITE 101
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City | ENUMCLAW
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State | WA
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Zip | 98022-3649
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Country | US
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Telephone | 360-825-4466
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Fax | 360-825-2064
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Authorized Official
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Title or Position | OWNER
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Name | DR. NANCY ANN BECKER
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Credential | DO
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Telephone | 360-825-4466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 602061246
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License Number State | WA
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