Organization
SURGERY CENTER AT ST. VINCENT, LLC
Active
Other names
East Pavilion Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE DUDLEY (CHIEF ADMINISTRATIVE OFFICER)
(971) 339-7791
Entity
Organization
Contact information
Practice address
9135 SW BARNES RD STE 161, PORTLAND, OR 97225
(971) 339-7791
Mailing address
9135 SW BARNES RD STE 161, PORTLAND, OR 97225-6646
(971) 339-7791
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/07/2018
Last updated
07/16/2019
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