Provider Demographics
NPI:1659136604
Name:ALCHEMY SKIN LAB & ELECTROLYSIS INC.
Entity Type:Organization
Organization Name:ALCHEMY SKIN LAB & ELECTROLYSIS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:ALFONSO
Authorized Official - Last Name:ALANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-390-0385
Mailing Address - Street 1:28306 NE 147TH CT
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-8134
Mailing Address - Country:US
Mailing Address - Phone:206-390-0385
Mailing Address - Fax:360-925-6589
Practice Address - Street 1:1106 COLUMBIA AVE STE 104
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4343
Practice Address - Country:US
Practice Address - Phone:360-502-7546
Practice Address - Fax:360-925-6589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty