Organization Active NPI

Surgery Center Enumclaw

  • Ambulatory Surgical Clinic/Center
  • Enumclaw, WA
National Provider Identifier
1649368341
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
FX00057007 Issued in WA
Legal business name
SURGERY CENTER ENUMCLAW
Practice address
2820 Griffin Ave
Suite 100
Enumclaw, WA 98022-2373
Phone
(360) 802-5231
Fax
(360) 802-5236
NPI assigned
Oct 10, 2006
Organization subpart
Yes
Parent organization
PUGET SOUND SPECIALTY PHYSICIANS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Authorized official

Name
David H Bishop, M.D.NPI 1194878702
Title
Board Chairman
Phone
(360) 825-7500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X FX00057007 WA Primary

Addresses

Primary practice location

2820 Griffin Ave
Suite 100
Enumclaw, WA 98022-2373

Mailing address

2820 Griffin Ave
Suite 100
Enumclaw, WA 98022-2373
Phone (360) 802-5231

National Provider Directory

National Provider Directory
Part of
Puget Sound Spec Phys PLLC

Locations

2820 Griffin Ave
Ste 100
Enumclaw, WA 98022
Phone (360) 802-5231

2820 Griffin Ave
Ste 101
Enumclaw, WA 98022
Phone (360) 825-2181

2820 Griffin Ave
Ste 200
Enumclaw, WA 98022
Phone (360) 825-2701

2005 NW Sammamish Rd
Bldg B
Issaquah, WA 98027
Phone (425) 394-0200

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1649368341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 GRIFFIN AVE",
            "address_2": "SUITE 100",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222373",
            "telephone_number": "360-802-5231",
            "fax_number": "360-802-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 GRIFFIN AVE",
            "address_2": "SUITE 100",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222373",
            "telephone_number": "360-802-5231",
            "fax_number": "360-802-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER ENUMCLAW",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUGET SOUND SPECIALTY PHYSICIANS, PLLC",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "360-825-7500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "FX00057007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enumclaw, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.