Organization
GOOD SAMARITAN SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN KASMAN (ADMINISTRATOR)
(253) 697-2074
Entity
Organization
Contact information
Practice address
1322 3RD ST SE, 100, PUYALLUP, WA 98372-3771
(253) 697-5700
(253) 840-2352
Mailing address
1322 3RD ST SE, 100, PUYALLUP, WA 98372-3771
(253) 697-5700
(253) 840-2352
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7030638
—
WA
Enumeration date
09/22/2005
Last updated
08/22/2020
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