Organization
CEDAR MEDICAL SPECIALTIES, PLLC
Active
Other names
Cedar Laser and Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN WALLACE (CLINICAL DIRECTOR)
(253) 830-5432
Entity
Organization
Contact information
Practice address
2202 S CEDAR ST, STE 150, TACOMA, WA 98405-2318
(253) 830-5432
(253) 830-5433
Mailing address
2202 S CEDAR ST, STE 150, TACOMA, WA 98405-2318
(253) 830-5432
(253) 830-5433
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
FX00057086
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7109994
—
WA
Enumeration date
05/08/2006
Last updated
09/08/2010
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