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Organization
DOCTORS CLINIC A PROFESSIONAL CORPORATION
Active
Organization
DOCTORS CLINIC A PROFESSIONAL CORPORATION
Active
Parent organization
DOCTORS CLINIC A PROFESSIONAL CORPORATION
Other names
THE DOCTORS CLINIC AMBULATORY SURGERY CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOCTORS CLINIC A PROFESSIONAL CORPORATION
Authorized official
JAY BURGHART (CEO)
(360) 782-3650
Entity
Organization
Contact information
Practice address
2200 NW MYHRE RD, SILVERDALE, WA 98383-7681
(360) 830-1100
(360) 830-1283
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
(360) 782-3650
(360) 782-3686
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
261QE0800X
Endoscopy Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7127996
—
WA
01
—
75420
LABOR & INDUSTRIES
WA
01
—
8937973
CRIME VICTIMS COMP PROG
WA
01
—
P00255455
RAILROAD MEDICARE
WA
Enumeration date
01/11/2007
Last updated
05/28/2015
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