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Organization
THE EASTSIDE ENDOSCOPY CENTER LLC
Active
Organization
THE EASTSIDE ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLAS GORALSKY (COO)
(253) 383-8342
Entity
Organization
Contact information
Practice address
1135 116TH AVE NE, SUITE 570, BELLEVUE, WA 98004-4623
(425) 451-7335
(425) 451-1226
Mailing address
1135 116TH AVE NE, BELLEVUE, WA 98004-4623
(425) 544-7684
(425) 462-8021
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15949
AAAHC ACCREDITATION
—
01
—
50D0923026
CLIA NUMBER
WA
05
—
7067366
—
WA
01
—
EA0308
REGENCE BS
WA
01
—
MTS-3102
STATE LICENSE
WA
Enumeration date
06/30/2005
Last updated
03/07/2023
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