Organization
PACIFIC SURGICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL D DALLY MD (OWNER)
(360) 213-9955
Entity
Organization
Contact information
Practice address
505 NE 87TH AVE, SUITE 301, VANCOUVER, WA 98664-1989
(360) 213-9955
Mailing address
PO BOX 23200, PORTLAND, OR 97281-3200
(360) 213-9955
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278191
—
OR
05
—
7128093
—
WA
Enumeration date
06/09/2006
Last updated
10/17/2007
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