Organization
NORTHWEST VEIN AND AESTHETIC CENTER PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AKSEL G NORDESTGAARD MD (PRESIDENT)
(253) 857-8346
Entity
Organization
Contact information
Practice address
4700 POINT FOSDICK DR NW STE 307, GIG HARBOR, WA 98335-1706
(253) 857-8346
(253) 857-0259
Mailing address
4700 POINT FOSDICK DR NW STE 307, GIG HARBOR, WA 98335-1706
(253) 857-8346
(253) 857-0259
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
MD00028685
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1067198
—
WA
01
—
1083630602
INDIVIDUAL NPI
WA
Enumeration date
02/18/2009
Last updated
02/18/2009
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