# SURGICAL WEIGHT LOSS CLINIC PLLC

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

## Provider details

- **NPI number:** 1811015399
- **Authorized official:** DR. SAMUEL ROSS FOX MD (OWNER & SURGEON)
- **Authorized official phone:** (253) 472-9850

## Contact information

- **Practice address:** 3716 PACIFIC AVE, SUITE B, TACOMA, WA 98418-7836
- **Practice address phone:** (253) 472-9850
- **Mailing address:** 3716 PACIFIC AVE, SUITE B, TACOMA, WA 98418-7836
- **Mailing address phone:** (253) 472-9850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | MD00005293 | WA | — |
| 261QM2500X | Medical Specialty Clinic/Center | MD0002094 | WA | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | WA | Yes |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 07/21/2022