Organization
NORTHWEST MOBILE ANESTHESIA GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE SONG M.D. (OWNER)
(360) 727-8044
Entity
Organization
Contact information
Practice address
17307 NE 32ND AVE, RIDGEFIELD, WA 98642-7972
(360) 727-8044
(360) 727-7924
Mailing address
17307 NE 32ND AVE, RIDGEFIELD, WA 98642-7972
(360) 727-8044
(360) 727-7924
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
MD00046439
WA
261QA1903X
Ambulatory Surgical Clinic/Center
MD28387
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124577
—
WA
Enumeration date
10/02/2008
Last updated
10/02/2008
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