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General NPI Number Information
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NPI Number | 1417276312
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Entity Type | Organization
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Legal Business Name | PACIFIC GYNECOLOGY SPECIALISTS, PC
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 02/05/2018
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Provider Practice Location Address
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Address Line | 1101 MADISON ST STE 1500
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City | SEATTLE
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State | WA
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Zip | 98104-3551
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Country | US
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Telephone | 206-965-1700
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Fax | 206-965-1736
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Provider Business Mailing Address
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Address Line | 1101 MADISON ST STE 1500
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City | SEATTLE
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State | WA
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Zip | 98104-3551
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Country | US
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Telephone | 206-965-1700
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Fax | 206-965-1736
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. KELLY WILLIAMSON
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Credential |
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Telephone | 206-965-1701
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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.60126789
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License Number State | WA
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