Provider Demographics
NPI:1053481960
Name:AESTHETIC ASSOCIATES INC., P.S.
Entity Type:Organization
Organization Name:AESTHETIC ASSOCIATES INC., P.S.
Other - Org Name:SEATTLE FACIAL PLASTIC SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING AND REIMBURSEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:CCS-P
Authorized Official - Phone:206-624-6200
Mailing Address - Street 1:1101 MADISON ST
Mailing Address - Street 2:SUITE 1280
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3510
Mailing Address - Country:US
Mailing Address - Phone:206-624-6200
Mailing Address - Fax:
Practice Address - Street 1:1101 MADISON ST
Practice Address - Street 2:SUITE 1280
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3510
Practice Address - Country:US
Practice Address - Phone:206-624-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601552697261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8866835Medicare PIN