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Organization

NORTHWEST SURGICAL GROUP PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM CLARENCE WILLIARD M.D. (PHYSICIAN)
(360) 754-1029
Entity
Organization

Contact information

Practice address
3920 CAPITOL MALL DR SW, SUITE 201, OLYMPIA, WA 98502-8700
(360) 754-1029
(390) 754-7885
Mailing address
3920 CAPITOL MALL DR SW, SUITE 201, OLYMPIA, WA 98502-8700
(360) 754-1029
(390) 754-7885

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
601009261
WA
208600000X
Surgery Physician
Primary
MD00029497
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7105182
WA
Enumeration date
07/05/2006
Last updated
05/31/2012
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