Organization Name:  THE EASTSIDE ENDOSCOPY CENTER LLC


Practice Location:
1135 116TH AVE NE SUITE 570 BELLEVUE, WA 98004 US
Tel: 425-451-7335  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical

Other Provider Identifiers:

Issuer	Number	State	Type
	7067366	WA	05
DEA LICENSE	BG4377227		01
CLIA NUMBER	50D0923026	WA	01
AAAHC ACCREDITATION	15949		01
REGENCE BS	EA0308	WA	01
STATE LICENSE	MTS-3102	WA	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin