Organization
PACIFIC RIM ORTHOPAEDIC SURGEONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KEVIN GANNON M.D. (PROVIDER)
(360) 733-7670
Entity
Organization
Contact information
Practice address
2979 SQUALICUM PKWY, SUITE #203, BELLINGHAM, WA 98225-1811
(360) 733-7670
(360) 647-1901
Mailing address
2979 SQUALICUM PKWY, SUITE #203, BELLINGHAM, WA 98225-1811
(360) 733-7670
(360) 647-1901
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD0022602
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
602120520
UBI
WA
Enumeration date
07/21/2006
Last updated
05/23/2013
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