Organization
PLASTIC SURGERY NORTHWEST ASC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAVIN M DRY MD (OWNER)
(425) 821-6000
Entity
Organization
Contact information
Practice address
13114 120TH AVE NE, KIRKLAND, WA 98034-3014
(425) 821-6000
(425) 820-6288
Mailing address
13114 120TH AVE NE, KIRKLAND, WA 98034-3014
(425) 821-6000
(425) 820-6288
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0151861
LABOR INDUSTRIES
WA
Enumeration date
02/06/2006
Last updated
08/22/2020
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