# PROVIDENCE SURGERY AND PROCEDURE CENTER LLC

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

## Provider details

- **NPI number:** 1205545860
- **Authorized official:** JONATHAN BAILEY (OFFICER/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (203) 609-1168

## Contact information

- **Practice address:** 16528 E DESMET CT, SPOKANE VALLEY, WA 99216-3522
- **Practice address phone:** (509) 944-8960
- **Mailing address:** 16528 E DESMET CT STE A2100, SPOKANE VALLEY, WA 99216-3522
- **Mailing address phone:** (509) 944-8960

## Taxonomy

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

## Other

- **Enumeration date:** 11/22/2022
- **Last updated:** 10/11/2024