Provider Demographics
NPI:1225377278
Name:CENTER FOR MINIMALLY INVASIVE SURGERY PLLC
Entity Type:Organization
Organization Name:CENTER FOR MINIMALLY INVASIVE SURGERY PLLC
Other - Org Name:SOUNDVIEW AMBULATORY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:RIFENBERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-572-7120
Mailing Address - Street 1:1802 YAKIMA AVE
Mailing Address - Street 2:202
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4499
Mailing Address - Country:US
Mailing Address - Phone:253-572-7120
Mailing Address - Fax:253-572-1071
Practice Address - Street 1:5801 SOUNDVIEW DR
Practice Address - Street 2:156
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-2095
Practice Address - Country:US
Practice Address - Phone:253-572-7120
Practice Address - Fax:253-572-1071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical