Northwest Surgical Services, PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00045973 Issued in WA

Legal business name

NORTHWEST SURGICAL SERVICES, PLLC

Practice address

1710 N 13TH Loop Rd
Shelton, WA 98584-2166

Phone

(360) 426-4142

Fax

(360) 427-5772

NPI assigned

Jul 4, 2006

Last updated

Sep 9, 2008By 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

Ms. Cheryl R Mahlberg, M.A.

Title

Office/Business Manager

Phone

(360) 426-4142

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Vanni Chendu Manthiram, MD

  • Surgery Physician
  • Palo Alto, CA
  • NPI 1326086372
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1467482679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 N 13TH LOOP RD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842166",
            "telephone_number": "360-426-4142",
            "fax_number": "360-427-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 N 13TH LOOP RD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842166",
            "telephone_number": "360-426-4142",
            "fax_number": "360-427-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SURGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "MAHLBERG",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE/BUSINESS MANAGER",
        "authorized_official_telephone_number": "360-426-4142",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00045973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy C. Nolda, MA
• Shannon Marie Northup
• Northwest Indian Treatment Center
• Northwest Indian Treatment Center
• Northwest Resources II
• Krystel Nysted, RN
• Caitlin O'Hea
• June Obrien, CDP
• John Sutherland Oglesby, M.D.
• Karin S Olsen, LMP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.