Organization
WILLAMETTE SPINE CENTER AMBULATORY SURGERY LLC
Active
Other names
Liberty Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. D KAY NEMEC RN (ADMINISTRATOR)
(503) 485-2290
Entity
Organization
Contact information
Practice address
2480 LIBERTY ST NE, SUITE 120, SALEM, OR 97303-6780
(503) 485-2290
Mailing address
PO BOX 1267, PORTLAND, OR 97207-1267
(503) 485-2290
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227889
—
OR
Enumeration date
07/21/2005
Last updated
08/22/2020
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