NPIMap

Organization Active NPI

Western Washington Endoscopy Centers LLC

  • Ambulatory Surgical Clinic/Center
  • Tacoma, WA
National Provider Identifier
1992765986
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
CON 1298 Issued in WA
Legal business name
WESTERN WASHINGTON ENDOSCOPY CENTERS LLC
Practice address
3209 South 23Rd St
2ND Floor
Tacoma, WA 98405
Phone
(253) 272-5127
Fax
(253) 272-0811
NPI assigned
Mar 24, 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 1298 WA Primary

Addresses

Primary practice location

3209 South 23Rd St
2ND Floor
Tacoma, WA 98405

Mailing address

PO Box 2157
Tacoma, WA 98401-2157
Phone (253) 272-5127

Other identifiers 1

IdentifierTypeStateIssuer
7137292MedicaidWA

Other names 1

  • Waldron Endoscopy Center Doing business as

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
O20160914001157 WA Part B Supplier - Ambulatory Surgical Center 7315991924 Practice locations: Tacoma, 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
Washington GastroenterologyCCN 50C0001126
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
50D1092366Waldron Endoscopy Center3209 S 23Rd St 2ND Floor, Tacoma, WA 98405Certificate 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": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1992765986",
    "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": "253-272-5127",
            "fax_number": "253-272-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 SOUTH 23RD ST",
            "address_2": "2ND FLOOR",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98405",
            "telephone_number": "253-272-5127",
            "fax_number": "253-272-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WASHINGTON ENDOSCOPY CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "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 1298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7137292",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waldron Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waldron Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, 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.