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Organization
CEDAR MEDICAL SPECIALTIES, PLLC
Active
Organization
CEDAR MEDICAL SPECIALTIES, PLLC
Active
Other names
Cedar Laser and Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN WALLACE (CLINICAL DIRECTOR)
(253) 830-5432
Entity
Organization
Contact information
Practice address
2202 S CEDAR ST, STE 150, TACOMA, WA 98405-2318
(253) 830-5432
(253) 830-5433
Mailing address
2202 S CEDAR ST, STE 150, TACOMA, WA 98405-2318
(253) 830-5432
(253) 830-5433
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
FX00057086
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7109994
—
WA
Enumeration date
05/08/2006
Last updated
09/08/2010
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