Organization
HIGH DESERT SURGERY CENTER, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNAE WILSON (OFFICE MANAGER)
(509) 736-2770
Entity
Organization
Contact information
Practice address
521 N YOUNG ST, KENNEWICK, WA 99336-7806
(509) 586-2828
(509) 586-2525
Mailing address
521 N YOUNG ST STE 100, KENNEWICK, WA 99336-7806
(509) 736-2770
(509) 736-2771
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
602776306
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240038
WASHINGTON STATE LABOR & INDUSTRIES
WA
05
—
7144918
—
WA
Enumeration date
11/07/2007
Last updated
04/19/2022
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