VICTOR R. MICHALAK NPI 1104877976

NPI Information

  • NPI: 1104877976
  • Provider Name: VICTOR R. MICHALAK
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: DBA COSMETIC SURGERY & DERMATOLOGY OF ISSAQUAH, INC.
  • Address: 295 NE GILMAN BLVD
    SUITE 101
    ISSAQUAH, WA
    ZIP 98027
  • Phone: (425) 391-2500

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NPI Details

VICTOR R. MICHALAK is an ambulatory surgical clinic center in Issaquah, WA. VICTOR R. MICHALAK NPI is 1104877976. The provider is registered as an organization entity type.
The provider Is Doing Business As Dba Cosmetic Surgery & Dermatology Of Issaquah, Inc..

The provider's business location address is:

295 NE GILMAN BLVD
SUITE 101
ISSAQUAH, WA
ZIP 98027
Phone: (425) 391-2500
Fax: (425) 391-6464

The provider's authorized official is Tanya Knott .
The authorized official title is Practice Administrator and has the following contact phone number (425) 391-2500.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less (HCPCS:15004)
  • Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less (HCPCS:14040)
  • Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less (HCPCS:14020)
  • Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm (HCPCS:14021)
  • Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less (HCPCS:14060)
  • Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm (HCPCS:14041)
  • Repair of wound of trunk by transferring skin, 10.0 sq cm or less (HCPCS:14000)

The enumeration date for this NPI number is 5/15/2006 and was last updated on 8/7/2018.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory Surgical50-C0001197WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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