Organization
MID-COLUMBIA SURGICAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARI GUTZLER (ADMINISTRATOR)
(541) 296-6101
Entity
Organization
Contact information
Practice address
1810 E 19TH ST STE 225, THE DALLES, OR 97058-3388
(541) 296-6101
(541) 296-0025
Mailing address
1810 E 19TH ST STE 225, THE DALLES, OR 97058-3388
(541) 296-6101
(541) 296-0025
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198150
—
OR
05
—
7023476
—
WA
Enumeration date
11/14/2006
Last updated
04/07/2015
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