ATHENIX PHYSICIANS GROUP NORTHWEST PLLC NPI 1801203310

NPI Information

ATHENIX PHYSICIANS GROUP NORTHWEST, PLLC is a plastic and reconstructive surgery surgery in Bellevue, WA. The provider is a surgeon who specializes in plastic and reconstructive surgery. ATHENIX PHYSICIANS GROUP NORTHWEST, PLLC NPI is 1801203310. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Athenix Body Sculpting Institute.

The provider's business location address is:

636 120TH AVE NE STE 202
BELLEVUE, WA
ZIP 98005-028
Phone: (425) 454-2410
Fax: (425) 454-2259

The provider's authorized official is James Haefner .
The authorized official title is Administration and has the following contact phone number (949) 600-9931.

The CLIA number assigned to this NPI record is 50D2039119 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/16/2014 and was last updated on 7/16/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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