Organization
THE DOCTORS CLINIC A PROFESSIONAL CORPORATION
Active
Other names
THE DOCTORS CLINIC SALMON MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JAY BURGHART (EXECUTIVE DIRECTOR)
(360) 782-3600
Entity
Organization
Contact information
Practice address
2200 NW MYHRE RD, SILVERDALE, WA 98383-7681
(360) 830-1100
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11945
CLIA
—
01
—
337018607
OWCP
—
05
—
7126790
—
WA
01
—
7127822
LABOR & INDUSTRY P.T.
WA
01
—
75420
LABOR & INDUSTRIES
WA
01
—
8903693
CRIME VICTIMS COMP
WA
01
—
CU0247
RAILROAD MEDICARE
WA
Enumeration date
05/28/2006
Last updated
11/01/2019
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