# VICTOR R. MICHALAK

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- **Entity:** Organization
- **Status:** Active
- **Other names:** dba Cosmetic Surgery & Dermatology of Issaquah, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104877976
- **Authorized official:** TANYA KNOTT (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (425) 391-2500

## Contact information

- **Practice address:** 295 NE GILMAN BLVD, SUITE 101, ISSAQUAH, WA 98027
- **Practice address phone:** (425) 391-2500
- **Practice address fax:** (425) 391-6464
- **Mailing address:** 295 NE GILMAN BLVD, SUITE 101, ISSAQUAH, WA 98027-2906
- **Mailing address phone:** (425) 391-2500
- **Mailing address fax:** (425) 391-6464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 50-C0001197 | WA | Yes |

## Other

- **Enumeration date:** 05/15/2006
- **Last updated:** 08/07/2018