# DOCTORS CLINIC A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DOCTORS CLINIC A PROFESSIONAL CORPORATION
- **Other names:** THE DOCTORS CLINIC AMBULATORY SURGERY CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073663480
- **Legal business name:** DOCTORS CLINIC A PROFESSIONAL CORPORATION
- **Authorized official:** JAY BURGHART (CEO)
- **Authorized official phone:** (360) 782-3650

## Contact information

- **Practice address:** 2200 NW MYHRE RD, SILVERDALE, WA 98383-7681
- **Practice address phone:** (360) 830-1100
- **Practice address fax:** (360) 830-1283
- **Mailing address:** 9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
- **Mailing address phone:** (360) 782-3650
- **Mailing address fax:** (360) 782-3686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |
| 261QE0800X | Endoscopy Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/11/2007
- **Last updated:** 05/28/2015

## 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 |