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Organization
SHADE MEDICAL AND CREATIVE TATTOO LLC
Active
Organization
SHADE MEDICAL AND CREATIVE TATTOO LLC
Active
Other names
Shade Tattoo Studio
Organization subpart
No
Provider details
NPI number
Authorized official
ALISSA CHRISTINE WATERS (OWNER/TATTOOIST)
(608) 770-5682
Entity
Organization
Contact information
Practice address
3230 UNIVERSITY AVE STE 12, MADISON, WI 53705-3540
(608) 571-2617
Mailing address
2201 WESTCHESTER RD, FITCHBURG, WI 53711-4370
(608) 770-5682
Taxonomy
Speciality
Code
Description
License number
State
246ZA2600X
Medical Art Specialist/Technologist
Primary
—
—
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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