THE EASTSIDE ENDOSCOPY CENTER LLC NPI 1992702443

NPI Information

NPI: 1992702443
Provider Name: THE EASTSIDE ENDOSCOPY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1135 116TH AVE NE
SUITE 570
BELLEVUE, WA
ZIP 98004
Phone: (425) 451-7335
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THE EASTSIDE ENDOSCOPY CENTER LLC is an ambulatory surgical clinic center in Bellevue, WA. THE EASTSIDE ENDOSCOPY CENTER LLC NPI is 1992702443. The provider is registered as an organization entity type.

The provider's business location address is:

1135 116TH AVE NE
SUITE 570
BELLEVUE, WA
ZIP 98004-623
Phone: (425) 451-7335
Fax: (425) 451-1226

The provider's authorized official is Nicolas Goralsky .
The authorized official title is Coo and has the following contact phone number (253) 383-8342.

The enumeration date for this NPI number is 6/30/2005 and was last updated on 9/25/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7067366	MEDICAID	WASHINGTON
2	EA0308	OTHER	WASHINGTON	REGENCE BS
3	=========	OTHER	WASHINGTON	PREMERA BC
4	50D0923026	OTHER	WASHINGTON	CLIA NUMBER
5	BG4377227	OTHER		DEA LICENSE
6	MTS-3102	OTHER	WASHINGTON	STATE LICENSE
7	15949	OTHER		AAAHC ACCREDITATION

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: 11/14/2023

NPI Synchronization or Removal

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