Provider Demographics
NPI:1003227273
Name:TREMBLAY-CHAMPAGNE, MARIE-PASCALE (MD, CM, FRCSC)
Entity Type:Individual
Prefix:
First Name:MARIE-PASCALE
Middle Name:
Last Name:TREMBLAY-CHAMPAGNE
Suffix:
Gender:F
Credentials:MD, CM, FRCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST. BOX 356410
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195
Mailing Address - Country:US
Mailing Address - Phone:206-543-5516
Mailing Address - Fax:206-598-2530
Practice Address - Street 1:1959 NE PACIFIC ST.
Practice Address - Street 2:DEPARTMENT OF SURGERY - DIVISION OF PLASTIC SURGERY
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195
Practice Address - Country:US
Practice Address - Phone:206-543-5516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-09
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60444712208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery