Plastic Surgery Northwest ASC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PLASTIC SURGERY NORTHWEST ASC

Practice address

13114 120TH Ave NE
Kirkland, WA 98034-3014

Phone

(425) 821-6000

Fax

(425) 820-6288

NPI assigned

Feb 6, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gavin M Dry, MD

Title

Owner

Phone

(425) 821-6000

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093787715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13114 120TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343014",
            "telephone_number": "425-821-6000",
            "fax_number": "425-820-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13114 120TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343014",
            "telephone_number": "425-821-6000",
            "fax_number": "425-820-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY NORTHWEST ASC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRY",
        "authorized_official_first_name": "GAVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-821-6000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR INDUSTRIES",
            "identifier": "0151861",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roya Amri Pinski
• Judith Piper
• Kim R Pittenger, MD
• Jada M Pitts
• Megan Pitts
• Krystal Plonski, N.D.
• Barbara A Plovie, ARNP
• PNC Podiatry of Washington PLLC
• Joshua Poling
• Kelli Polite

• Ambulatory Surgical Clinic/Center in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.