Provider Demographics
NPI:1942859160
Name:ESTHETICS NW SERVICES LLC
Entity Type:Organization
Organization Name:ESTHETICS NW SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGA
Authorized Official - Suffix:
Authorized Official - Credentials:CPCP
Authorized Official - Phone:541-344-7789
Mailing Address - Street 1:81 CENTENNIAL LOOP STE 3
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2471
Mailing Address - Country:US
Mailing Address - Phone:541-344-7789
Mailing Address - Fax:
Practice Address - Street 1:81 CENTENNIAL LOOP STE 3
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2471
Practice Address - Country:US
Practice Address - Phone:541-344-7789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, MedicalGroup - Single Specialty