Organization
SHADE MEDICAL AND CREATIVE TATTOO LLC
Active
Other names
Shade Tattoo Studio
Organization subpart
No
Provider details
NPI number
Authorized official
ALISSA CHRISTINE WATERS (OWNER/TATTOOIST)
(608) 770-5682
Entity
Organization
Contact information
Practice address
3230 UNIVERSITY AVE STE 12, MADISON, WI 53705-3540
(608) 571-2617
Mailing address
2201 WESTCHESTER RD, FITCHBURG, WI 53711-4370
(608) 770-5682
Taxonomy
Speciality
Code
Description
License number
State
246ZA2600X
Medical Art Specialist/Technologist
Primary
—
—
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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