Provider Demographics
NPI:1609620772
Name:SALISH SPECIALTY SERVICES LLC
Entity type:Organization
Organization Name:SALISH SPECIALTY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:O
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-447-1340
Mailing Address - Street 1:3700 PACIFIC HWY E STE 304
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-1162
Mailing Address - Country:US
Mailing Address - Phone:253-246-5001
Mailing Address - Fax:253-645-2735
Practice Address - Street 1:3700 PACIFIC HWY E STE 304
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-1162
Practice Address - Country:US
Practice Address - Phone:253-219-8747
Practice Address - Fax:253-645-2735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA35-2880096OtherIRS