Provider Demographics
NPI:1962022566
Name:TL SURGICAL ASSISTANTS
Entity Type:Organization
Organization Name:TL SURGICAL ASSISTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:LAREE
Authorized Official - Last Name:ALFANO
Authorized Official - Suffix:
Authorized Official - Credentials:SA-C
Authorized Official - Phone:360-601-2984
Mailing Address - Street 1:13720 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5055
Mailing Address - Country:US
Mailing Address - Phone:360-601-2984
Mailing Address - Fax:
Practice Address - Street 1:13720 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-5055
Practice Address - Country:US
Practice Address - Phone:360-601-2984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty