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General NPI Number Information
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NPI Number | 1982871950
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Entity Type | Organization
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Legal Business Name | ARTISTIC PLASTIC SURGERY CENTER PLLC
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 3515 S 15TH ST SUITE #101
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City | TACOMA
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State | WA
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Zip | 98405-1952
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Country | US
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Telephone | 253-756-0933
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Fax | 253-759-6553
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Provider Business Mailing Address
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Address Line | 3515 S 15TH ST SUITE #101
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City | TACOMA
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State | WA
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Zip | 98405-1952
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Country | US
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Telephone | 253-756-0933
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Fax | 253-759-6553
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | BRIDGET M LASON
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Credential |
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Telephone | 253-756-0933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 602804600
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License Number State | WA
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