Pacific Northwest Plastic Surgery, Ps in University Place - Specialist
Pacific Northwest Plastic Surgery, Ps - NPI 1205951910
Pacific Northwest Plastic Surgery, Ps is a Specialist in University Place, Washington. Pacific Northwest Plastic Surgery, Ps practices all healthcare services and medical treatments related to Specialist. The NPI Number for Pacific Northwest Plastic Surgery, Ps is 1205951910. The last update date is 2012-01-18.
Pacific Northwest Plastic Surgery, Ps's current location address is 5016 Bridgeport Way W, University Place, Washington. You can contact this provider via phone number 2537619515 and fax number 2537611306. The mailing address for Pacific Northwest Plastic Surgery, Ps is 5016 Bridgeport Way W, University Place, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pacific Northwest Plastic Surgery, Ps |
|---|---|
| Address | 5016 Bridgeport Way W, University Place, Washington |
| Phone Number | 2537619515 |
| Fax Number | 2537611306 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Realica Maglaque Ross |
| Credentials | MD |
| Telephone Number | 2537619515 |
NPI Number Detail
| NPI Number | 1205951910 |
|---|---|
| Provider Enumeration Date | 2007-03-20 |
| Last Updated Date | 2012-01-18 |
Provider Mailing Address Detail
| Address | 5016 Bridgeport Way W |
|---|---|
| City | University Place |
| State | Washington (WA) |
| Post Code | 984672039 |
| Phone Number | 2537619515 |
| Fax Number | 2537611306 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 37332 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1107846 | WA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Pacific Northwest Plastic Surgery, Ps by the Centers for Medicare & Medicaid Services (CMS)?
The Pacific Northwest Plastic Surgery, Ps has been assigned the NPI (National Provider Identifier) 1205951910. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical address where Pacific Northwest Plastic Surgery, Ps is geographically located?
The Pacific Northwest Plastic Surgery, Ps is physically situated at the following location: 5016 Bridgeport Way W, University Place, WA, 984672039.
What is the Pacific Northwest Plastic Surgery, Ps's area of specialization and corresponding taxonomy classification?
The Pacific Northwest Plastic Surgery, Ps's specialty field is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their specialties.
On what date did the Pacific Northwest Plastic Surgery, Ps receive the assignment of its 1205951910 from the Centers for Medicare & Medicaid Services?
The Pacific Northwest Plastic Surgery, Ps was issued its 1205951910 by the Centers for Medicare & Medicaid Services on 2007-03-20.
As of what date were the details related to Pacific Northwest Plastic Surgery, Ps most recently updated or revised?
The information pertaining to Pacific Northwest Plastic Surgery, Ps, including its address, specialty, and other relevant details, was last updated or revised on 2012-01-18.
NPI Number: 1356344279
Address: Mount St. Mary's Hospital Laboratory, Lewiston, NY