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Organization
PROVIDENCE SURGERY AND PROCEDURE CENTER LLC
Active
Organization
PROVIDENCE SURGERY AND PROCEDURE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BAILEY (OFFICER/AUTHORIZED OFFICIAL)
(203) 609-1168
Entity
Organization
Contact information
Practice address
16528 E DESMET CT, SPOKANE VALLEY, WA 99216-3522
(509) 944-8960
Mailing address
16528 E DESMET CT STE A2100, SPOKANE VALLEY, WA 99216-3522
(509) 944-8960
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/22/2022
Last updated
10/11/2024
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