SB Surgical Assistant, LLC

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

RN00110231 Issued in WA

Legal business name

SB SURGICAL ASSISTANT, LLC

Practice address

20659 Bulson Rd
Mount Vernon, WA 98274-8032

Phone

(360) 445-3030

NPI assigned

Feb 24, 2015

Last updated

Feb 24, 2015By 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

Staci Bottles, RN

Title

Owner

Phone

(360) 445-3030

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1437541620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 803",
            "city": "CONWAY",
            "state": "WA",
            "postal_code": "982380803",
            "telephone_number": "360-445-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20659 BULSON RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982748032",
            "telephone_number": "360-445-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SB SURGICAL ASSISTANT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "BOTTLES",
        "authorized_official_first_name": "STACI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-445-3030",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "WA",
            "license": "RN00110231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Marie Santos, MD
• Cherry Rose Vilar Santos, ARNP
• Jhoanna M. Santos, MD
• Jennifer Sass-Walton, RN
• Lorraine Tracy Savage-Tibbott, M.A., CCC-SLP
• Timothy Tony Allan Schaefer, DO
• Catharine L. Schaeffer, ARNP
• Emily J Schafer, LMP
• Erin L Schaner, PA-C
• Zachary Scheunemann, DC

• Registered Nurse First Assistant in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Registered Nurse First Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.