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Organization
SKIN SURGERY CENTER PS
Active
Organization
SKIN SURGERY CENTER PS
Active
Other names
Skin Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
PETER BRIERLEY ODLAND MD (PRESIDENT)
(206) 346-6647
Entity
Organization
Contact information
Practice address
1551 116TH AVE NE, BELLEVUE, WA 98004-3814
(425) 453-8647
(425) 455-5727
Mailing address
1229 MADISON ST, SUITE 1480, SEATTLE, WA 98104-3586
(206) 346-6647
(206) 346-6022
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8080SK
BC BS
—
Enumeration date
10/17/2006
Last updated
04/20/2008
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