# NORTH KITSAP AMBULATORY SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pacific Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962402503
- **Authorized official:** JAMIE FOWLER (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (360) 779-6527

## Contact information

- **Practice address:** 20669 BOND RD NE, SUITE 200, POULSBO, WA 98370-6525
- **Practice address phone:** (360) 779-6527
- **Practice address fax:** (360) 697-2743
- **Mailing address:** 20669 BOND RD NE, SUITE 200, POULSBO, WA 98370-6525
- **Mailing address phone:** (360) 779-6527
- **Mailing address fax:** (360) 697-2743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 600558138 | WA | Yes |

## Other

- **Enumeration date:** 07/26/2005
- **Last updated:** 12/28/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7009293 | — | WA |