# PACIFIC NORTHWEST FACIAL PLASTIC SURGERY

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

## Provider details

- **NPI number:** 1902034770
- **Authorized official:** DR. WAYNE FOX LARRABEE M.D. (PHYSICIAN/OWNER)
- **Authorized official phone:** (206) 386-3550

## Contact information

- **Practice address:** 600 BROADWAY, SUITE 280, SEATTLE, WA 98122-5395
- **Practice address phone:** (206) 386-3550
- **Practice address fax:** (206) 386-3553
- **Mailing address:** 600 BROADWAY, SUITE 280, SEATTLE, WA 98122-5395
- **Mailing address phone:** (206) 386-3550
- **Mailing address fax:** (206) 386-3553

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/30/2009
- **Last updated:** 06/30/2009