Organization
THORACIC & CARDIOVASCULAR SURGERY INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI A BURRELL (OFFICE MANAGER)
(509) 452-0279
Entity
Organization
Contact information
Practice address
602 N 39TH AVE, 200, YAKIMA, WA 98902
(509) 452-0279
(509) 457-6306
Mailing address
602 N 39TH AVE, 200, YAKIMA, WA 98902
(509) 452-0279
(509) 457-6306
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048700
LABOR & INDUSTRIES
WA
05
—
7059694
—
WA
01
—
8902478
CRIME VICTIMS
WA
Enumeration date
01/03/2007
Last updated
05/05/2016
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