Organization
WESTERN WASHINGTON MEDICAL GROUP, INC, PS
Active
Other names
DBA: Gateway Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLINE H. SULLIVAN (ADMINISTRATOR)
(425) 374-5176
Entity
Organization
Contact information
Practice address
3726 BROADWAY SUITE 206, EVERETT, WA 98201-3787
(425) 374-5160
(425) 374-5161
Mailing address
3726 BROADWAY SUITE 206, EVERETT, WA 98201-3787
(425) 374-5160
(425) 374-5161
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7139009
—
WA
Enumeration date
05/01/2007
Last updated
10/29/2018
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