Organization
OLYMPIC PLASTIC SURGERY SUITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUZANNE M FLETCHER (ADMINISTRATOR)
(360) 415-0762
Entity
Organization
Contact information
Practice address
2600 CHERRY AVENUE, SUITE 201, BREMERTON, WA 98310
(360) 415-0762
(360) 792-1166
Mailing address
2600 CHERRY AVENUE, SUITE 201, BREMERTON, WA 98310
(360) 415-0762
(360) 792-1166
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55649
L & I
WA
05
—
7041791
—
WA
Enumeration date
03/22/2007
Last updated
07/27/2009
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