Organization
WESTSIDE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT WILLIAMS (CEO)
(503) 558-7372
Entity
Organization
Contact information
Practice address
13240 SW PACIFIC HWY, SUITE 200, TIGARD, OR 97223-4828
(503) 639-6571
(503) 624-6037
Mailing address
11086 SE OAK ST, MILWAUKIE, OR 97222-6692
(503) 557-2020
(503) 344-5110
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
07-1548
OR
261QS0132X
Ophthalmologic Surgery Clinic/Center
07-1548
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275090
—
OR
Enumeration date
11/10/2005
Last updated
02/22/2024
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