# CADDELLS LASER & ELECTROLYSIS CLINIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740068279
- **Authorized official:** MATTHEW DUNN (MANAGER)
- **Authorized official phone:** (206) 488-2215

## Contact information

- **Practice address:** 40 LAKE BELLEVUE DR STE 101, BELLEVUE, WA 98005-2479
- **Practice address phone:** (425) 998-0181
- **Mailing address:** 40 LAKE BELLEVUE DR STE 101, BELLEVUE, WA 98005-2479

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2023
- **Last updated:** 09/18/2023