Organization
PNW SURGICAL ASSISTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER LAURENT CSFA (PRESIDENT)
(971) 678-2298
Entity
Organization
Contact information
Practice address
7300 SW CHILDS RD STE A, TIGARD, OR 97224-7772
(503) 612-8452
Mailing address
740 MAIN ST, FAIRVIEW, OR 97024-1909
(971) 678-2298
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
01/19/2022
Last updated
01/20/2022
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