Provider Demographics
NPI:1619937059
Name:NORTHWEST SURGICAL ASSISTANTS INC
Entity Type:Organization
Organization Name:NORTHWEST SURGICAL ASSISTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HARVEY
Authorized Official - Last Name:GLOS
Authorized Official - Suffix:
Authorized Official - Credentials:CST/CFA
Authorized Official - Phone:303-455-8812
Mailing Address - Street 1:PO BOX 11729
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-0729
Mailing Address - Country:US
Mailing Address - Phone:303-455-8812
Mailing Address - Fax:303-480-1109
Practice Address - Street 1:4868 WYANDOT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-1368
Practice Address - Country:US
Practice Address - Phone:303-455-8812
Practice Address - Fax:303-480-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCERTIFICATION 90771246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty