Organization
NORTHWEST WEIGHT LOSS SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAIA E LUKEVICH RN, BSN, RNFA, CASC (ADMINISTRATOR)
(425) 385-2263
Entity
Organization
Contact information
Practice address
125 130TH ST SE, FIRST FLOOR, EVERETT, WA 98208-6400
(425) 385-2263
(425) 385-8476
Mailing address
125 130TH ST SE, EVERETT, WA 98208-6400
(425) 341-4800
(425) 385-8476
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
602225209
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
602225209
STATE LICENSE BUSINESS ID
WA
Enumeration date
05/15/2006
Last updated
03/21/2012
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