Organization
ISLAND SURGEONS PS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MAXWELL (MANAGER)
(360) 293-5142
Entity
Organization
Contact information
Practice address
1213 24TH ST, SUITE 700, ANACORTES, WA 98221-2592
(360) 293-5142
(390) 299-2043
Mailing address
1213 24TH ST, SUITE 700, ANACORTES, WA 98221-2592
(360) 293-5142
(390) 299-2043
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
064973001
GROUP HEALTH
WA
01
—
33480
LABOR AND INDUSTRIES
WA
05
—
7743206
—
WA
01
—
W103051
TRICARE
WA
Enumeration date
12/07/2006
Last updated
05/22/2008
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