# CEDAR MEDICAL SPECIALTIES, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cedar Laser and Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194774265
- **Authorized official:** ROBYN WALLACE (CLINICAL DIRECTOR)
- **Authorized official phone:** (253) 830-5432

## Contact information

- **Practice address:** 2202 S CEDAR ST, STE 150, TACOMA, WA 98405-2318
- **Practice address phone:** (253) 830-5432
- **Practice address fax:** (253) 830-5433
- **Mailing address:** 2202 S CEDAR ST, STE 150, TACOMA, WA 98405-2318
- **Mailing address phone:** (253) 830-5432
- **Mailing address fax:** (253) 830-5433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | FX00057086 | WA | Yes |

## Other

- **Enumeration date:** 05/08/2006
- **Last updated:** 09/08/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7109994 | — | WA |