Provider Demographics
NPI:1447445424
Name:SURGICAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:SURGICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:REUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-493-5252
Mailing Address - Street 1:3610 ENSIGN RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5025
Mailing Address - Country:US
Mailing Address - Phone:360-493-5252
Mailing Address - Fax:
Practice Address - Street 1:3610 ENSIGN RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5025
Practice Address - Country:US
Practice Address - Phone:360-493-5252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7075963Medicaid