NPIMap

Organization Active NPI

Western Washington Endoscopy Centers LLC

  • Ambulatory Surgical Clinic/Center
  • Puyallup, WA
National Provider Identifier
1790744175
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
CON 1301 REQUIRED Issued in WA
Legal business name
WESTERN WASHINGTON ENDOSCOPY CENTERS LLC
Practice address
1703 S Meridian
Suite 203
Puyallup, WA 98371-7590
Phone
(253) 841-3933
Fax
(253) 864-8412
NPI assigned
Mar 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Authorized official

Name
Mr. Jeffrey Snodgrass
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X CON 1301 REQUIRED WA Primary

Addresses

Primary practice location

1703 S Meridian
Suite 203
Puyallup, WA 98371-7590

Mailing address

PO Box 2157
Tacoma, WA 98401-2157
Phone (253) 841-3933

Other identifiers 1

IdentifierTypeStateIssuer
7137326MedicaidWA

Other names 1

  • Puyallup Endoscopy Center Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050308000081 WA Part B Supplier - Ambulatory Surgical Center 7315991924 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gig Harbor, WA
O20160914000808 WA Part B Supplier - Ambulatory Surgical Center 7315991924 Practice locations: Puyallup, WA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Puyallup Endoscopy CenterCCN 50C0001184
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1092367Puyallup Endoscopy Center1703 S Meridian Ste 203, Puyallup, WA 98371Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1790744175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2157",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984012157",
            "telephone_number": "253-841-3933",
            "fax_number": "253-864-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN",
            "address_2": "SUITE 203",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-841-3933",
            "fax_number": "253-864-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WASHINGTON ENDOSCOPY CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "CON 1301 REQUIRED",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7137326",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Puyallup Endoscopy Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Puyallup Endoscopy Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.