# HIGH DESERT SURGERY CENTER, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033399084
- **Authorized official:** JENNAE WILSON (OFFICE MANAGER)
- **Authorized official phone:** (509) 736-2770

## Contact information

- **Practice address:** 521 N YOUNG ST, KENNEWICK, WA 99336-7806
- **Practice address phone:** (509) 586-2828
- **Practice address fax:** (509) 586-2525
- **Mailing address:** 521 N YOUNG ST STE 100, KENNEWICK, WA 99336-7806
- **Mailing address phone:** (509) 736-2770
- **Mailing address fax:** (509) 736-2771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 602776306 | WA | Yes |

## Other

- **Enumeration date:** 11/07/2007
- **Last updated:** 04/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 240038 | WASHINGTON STATE LABOR & INDUSTRIES | WA |
| 05 | — | 7144918 | — | WA |