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SOUTH SOUND SURGICAL ASSOCIATES NPI 1639261258


NPI Information

NPI: 1639261258
Provider Name: SOUTH SOUND SURGICAL ASSOCIATES
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
3900 CAPITAL MALL DR SW
OLYMPIA, WA
ZIP 98502
Phone: (360) 754-5858
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SOUTH SOUND SURGICAL ASSOCIATES is a vascular surgery surgery in Olympia, WA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. SOUTH SOUND SURGICAL ASSOCIATES NPI is 1639261258. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3900 CAPITAL MALL DR SW
OLYMPIA, WA
ZIP 98502-654
Phone: (360) 754-5858

The provider's authorized official is David Fj Tollefson .
The authorized official title is Managing Partner and has the following contact phone number (360) 280-6612.

The enumeration date for this NPI number is 9/29/2006 and was last updated on 11/1/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgery601814468WASHINGTONNo
22086S0129XSurgeryVascular SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17085947MEDICAIDWASHINGTON
2115566OTHERWASHINGTONLABOR AND INDUSTRIES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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