Provider Demographics
NPI:1710385505
Name:FACIALBEAUTY.COM,PLLC
Entity Type:Organization
Organization Name:FACIALBEAUTY.COM,PLLC
Other - Org Name:SNORE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:D
Authorized Official - Last Name:FORYSIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-973-3212
Mailing Address - Street 1:2620 BELLEVUE WAY NE # 125
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2209
Mailing Address - Country:US
Mailing Address - Phone:425-227-4000
Mailing Address - Fax:
Practice Address - Street 1:1260 116TH AVE NE STE 110
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3800
Practice Address - Country:US
Practice Address - Phone:425-227-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030977261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE74518Medicare UPIN