# NORTHWEST WEIGHT LOSS SURGERY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northwest Weight Loss Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487693800
- **Authorized official:** MRS. GAIA E LUKEVICH RN, BSN, RNFA, CASC (ADMINISTRATOR)
- **Authorized official phone:** (425) 385-2263

## Contact information

- **Practice address:** 125 130TH ST SE, FIRST FLOOR, EVERETT, WA 98208-6400
- **Practice address phone:** (425) 385-2263
- **Practice address fax:** (425) 385-8476
- **Mailing address:** 125 130TH ST SE, EVERETT, WA 98208-6400
- **Mailing address phone:** (425) 341-4800
- **Mailing address fax:** (425) 385-2931

## Taxonomy

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

## Other

- **Enumeration date:** 06/05/2006
- **Last updated:** 03/21/2012