Provider Demographics
NPI:1982871950
Name:ARTISTIC PLASTIC SURGERY CENTER PLLC
Entity Type:Organization
Organization Name:ARTISTIC PLASTIC SURGERY CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:M
Authorized Official - Last Name:LASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-756-0933
Mailing Address - Street 1:3515 S 15TH ST
Mailing Address - Street 2:SUITE #101
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1952
Mailing Address - Country:US
Mailing Address - Phone:253-756-0933
Mailing Address - Fax:253-759-6553
Practice Address - Street 1:3515 S 15TH ST
Practice Address - Street 2:SUITE #101
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1952
Practice Address - Country:US
Practice Address - Phone:253-756-0933
Practice Address - Fax:253-759-6553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602804600261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty