Organization
SKIN SURGERY CENTER PS
Active
Other names
Skin Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
PETER BRIERLEY ODLAND MD (PRESIDENT)
(206) 346-6647
Entity
Organization
Contact information
Practice address
1229 MADISON ST, SUITE 1480, SEATTLE, WA 98104-3586
(206) 346-6647
(206) 346-6022
Mailing address
1229 MADISON ST, SUITE 1480, SEATTLE, WA 98104-3586
(206) 346-6647
(206) 346-6022
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7070SK
BCBS
—
Enumeration date
10/17/2006
Last updated
04/20/2008
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