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General NPI Number Information
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NPI Number | 1306973235
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Entity Type | Organization
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Legal Business Name | DIGESTIVE DISEASE & ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 3261 NW MOUNT VINTAGE WAY STE 221
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City | SILVERDALE
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State | WA
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Zip | 98383-6039
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Country | US
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Telephone | 360-792-9118
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Fax | 360-918-9726
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Provider Business Mailing Address
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Address Line | 3261 NW MOUNT VINTAGE WAY STE 221
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City | SILVERDALE
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State | WA
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Zip | 98383-6039
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Country | US
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Telephone | 360-479-1952
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Fax | 360-918-9726
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Authorized Official
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Title or Position | CEO
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Name | JUSTIN SAETRUM
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Credential |
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Telephone | 360-479-1952
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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 | ASF.FS.60287214
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License Number State | WA
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