Healthcare Provider Details

I. General information

NPI: 1720865736
Provider Name (Legal Business Name): TS ELECTROLYSIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5123 NE 94TH AVE STE A
VANCOUVER WA
98662-6181
US

IV. Provider business mailing address

3405 SE 13TH AVE
PORTLAND OR
97202-2801
US

V. Phone/Fax

Practice location:
  • Phone: 801-631-0352
  • Fax:
Mailing address:
  • Phone: 801-631-0352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: TATIANA STEIN
Title or Position: OWNER
Credential:
Phone: 801-631-0352