Organization
SPOKANE SURGERY CENTER LTD PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEWART PUGMIRE BRIM DPM (OWNER PRESIDENT)
(509) 928-1990
Entity
Organization
Contact information
Practice address
12109 E BROADWAY AVE STE C, SPOKANE VALLEY, WA 99206-6133
(509) 928-1990
(509) 928-2933
Mailing address
12109 E BROADWAY AVE STE C, SPOKANE VALLEY, WA 99206-6133
(509) 928-1990
(509) 928-2933
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117682
LABOR & INDUSTRY
WA
01
—
490000540
RAILROAD MEDICARE
WA
05
—
7087760
—
WA
Enumeration date
05/02/2006
Last updated
12/04/2024
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