Provider Demographics
NPI:1851575922
Name:COSMETIC SURGICAL ARTS CENTER, INC.P.S.
Entity Type:Organization
Organization Name:COSMETIC SURGICAL ARTS CENTER, INC.P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MATHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-744-7771
Mailing Address - Street 1:19109 36TH AVE W STE 109
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5767
Mailing Address - Country:US
Mailing Address - Phone:425-744-7771
Mailing Address - Fax:425-744-7774
Practice Address - Street 1:19109 36 AVE W #109
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5767
Practice Address - Country:US
Practice Address - Phone:425-744-7771
Practice Address - Fax:425-744-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020164261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical