Organization
SURGERY CENTER OF SILVERDALE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE REITER MD (AUTHORIZED OFFICIAL)
(360) 692-2728
Entity
Organization
Contact information
Practice address
9800 LEVIN RD NW # 102, SILVERDALE, WA 98383-7856
(360) 692-2728
(360) 692-6009
Mailing address
9800 LEVIN RD NW # 102, SILVERDALE, WA 98383-7856
(360) 692-2728
(360) 692-6009
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
602478678
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7138217
—
WA
01
—
P00403366
RAILROAD MEDICARE
—
Enumeration date
12/18/2006
Last updated
10/23/2020
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