# SALMON CREEK PLASTIC SURGERY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Salmon Creek Plastic Surgery PC/ASC Facility
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588802466
- **Authorized official:** DR. RICHARD K GREEN M.D. (BUSINESS OWNER / PLASTIC SURGEON)
- **Authorized official phone:** (360) 823-0860

## Contact information

- **Practice address:** 13712 NE 10TH AVE, VANCOUVER, WA 98685
- **Practice address phone:** (360) 823-0860
- **Practice address fax:** (360) 828-1407
- **Mailing address:** 13712 NE 10TH AVE, VANCOUVER, WA 98685
- **Mailing address phone:** (360) 823-0860
- **Mailing address fax:** (360) 828-1407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | — | NULL | — |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 602673506 | WA | Yes |

## Other

- **Enumeration date:** 01/30/2009
- **Last updated:** 12/29/2022