Pacific Surgical Specialists LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PACIFIC SURGICAL SPECIALISTS LLC

Practice address

505 NE 87TH Ave
Suite 301
Vancouver, WA 98664-1989

Phone

(360) 213-9955

NPI assigned

Jun 9, 2006

Last updated

Oct 17, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paul D Dally, MDNPI 1548202088

Title

Owner

Phone

(360) 213-9955

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul D Dally, MD

  • Surgery Physician
  • Vancouver, WA
  • NPI 1548202088
  NPD (past) Authorized official
• Leslie A Cagle, MD

  • Surgery Physician
  • Vancouver, WA
  • NPI 1508802869
  NPD (past)
• Steven Matous, MD

  • Surgery Physician
  • Vancouver, WA
  • NPI 1871534594
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1265473623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972813200",
            "telephone_number": "360-213-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVE",
            "address_2": "SUITE 301",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641989",
            "telephone_number": "360-213-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC SURGICAL SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "DALLY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-213-9955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278191",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7128093",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Northwest Specialty Pharmacy LLC (Pacific NW Specialty Pharmacy, LLC)
• Pacific NW Relational Therapy, PLLC
• Pacific Optical Inc (Pacific Optical)
• Pacific Pediatric Feeding Team
• Pacific Phoenix Group PLLC (Pacific Phoenix Psychiatry)
• Pacific Surgical Specialists, PLLC
• Pacific Trillium Counseling LLC
• Pacifica Sylvan Park LLC (Pacifica Senior Living Vancouver)
• Margaret Pack, FNP-BC
• Jimmy Padar

• Surgery Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.