# NORTHWEST SURGICAL DEVELOPMENT OF BELLEVUE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Athenix Body Sculpting Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578970117
- **Authorized official:** MR. JAMES HAEFNER (CEO)
- **Authorized official phone:** (949) 600-9931

## Contact information

- **Practice address:** 636 120TH AVE NE STE 202, BELLEVUE, WA 98005-3028
- **Practice address phone:** (425) 454-2410
- **Practice address fax:** (425) 454-2259
- **Mailing address:** 65 ENTERPRISE STE 125, ALISO VIEJO, CA 92656-2706
- **Mailing address phone:** (949) 600-9931
- **Mailing address fax:** (949) 600-8029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | ASF.FS.60329939 | WA | Yes |

## Other

- **Enumeration date:** 07/15/2014
- **Last updated:** 02/10/2015