Organization Active NPI

Surgical Associates NW

  • Specialist
  • Federal Way, WA
National Provider Identifier
1871777201
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SURGICAL ASSOCIATES NW
Practice address
34612 6TH Ave S
Suite 110
Federal Way, WA 98003-8723
Phone
(253) 661-2594
Fax
(253) 661-2694
NPI assigned
Dec 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Authorized official

Name
Pam Stanfill
Title
Office Manager
Phone
(253) 661-2594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

34612 6TH Ave S
Suite 110
Federal Way, WA 98003-8723

Mailing address

34612 6TH Ave S
Suite 110
Federal Way, WA 98003-8723
Phone (253) 661-2594

Other identifiers 1

IdentifierTypeStateIssuer
7125081MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Surgical Associates Northwest PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1871777201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34612 6TH AVE S",
            "address_2": "SUITE 110",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038723",
            "telephone_number": "253-661-2594",
            "fax_number": "253-661-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34612 6TH AVE S",
            "address_2": "SUITE 110",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038723",
            "telephone_number": "253-661-2594",
            "fax_number": "253-661-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES NW",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "STANFILL",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-661-2594"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7125081",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.