Organization
NORTHWEST SURGICAL DEVELOPMENT
Active
Other names
Athenix Body Sculpting
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA GILLETT (INSURANCE SPECIALIST)
(949) 600-9941
Entity
Organization
Contact information
Practice address
17885 NW EVERGREEN PKWY, BEAVERTON, OR 97006-7494
(971) 246-5291
Mailing address
65 ENTERPRISE STE 125, ALISO VIEJO, CA 92656-2706
(949) 600-9941
(949) 600-8029
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
16741689
OR
Other
Enumeration date
07/12/2017
Last updated
07/12/2017
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