# PACIFIC NORTHWEST SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1912641788
- **Authorized official:** GREGORY ANTHONY MOORE MD (PARTNER)
- **Authorized official phone:** (541) 352-3661

## Contact information

- **Practice address:** 2445 BEVERLY ST, SPRINGFIELD, OR 97477-1910
- **Practice address phone:** (541) 284-3052
- **Practice address fax:** (541) 780-6645
- **Mailing address:** 2445 BEVERLY ST, SPRINGFIELD, OR 97477-1910
- **Mailing address phone:** (541) 284-3052
- **Mailing address fax:** (541) 780-6645

## Taxonomy

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

## Other

- **Enumeration date:** 04/26/2022
- **Last updated:** 05/12/2023