Provider Demographics
NPI:1922508514
Name:NORTHSTARR CARDIOTHORACIC SURGERY, LLC
Entity Type:Organization
Organization Name:NORTHSTARR CARDIOTHORACIC SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-297-1419
Mailing Address - Street 1:PO BOX 35145
Mailing Address - Street 2:#196240
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-5145
Mailing Address - Country:US
Mailing Address - Phone:503-297-1419
Mailing Address - Fax:503-512-7916
Practice Address - Street 1:3841 PIPER ST # T382
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4624
Practice Address - Country:US
Practice Address - Phone:907-917-2200
Practice Address - Fax:907-865-7944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty