Organization
NORTHWEST SURGICAL DEVELOPMENT OF BELLEVUE LLC
Active
Other names
Athenix Body Sculpting Institute
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES HAEFNER (CEO)
(949) 600-9931
Entity
Organization
Contact information
Practice address
636 120TH AVE NE STE 202, BELLEVUE, WA 98005-3028
(425) 454-2410
(425) 454-2259
Mailing address
65 ENTERPRISE STE 125, ALISO VIEJO, CA 92656-2706
(949) 600-9931
(949) 600-8029
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ASF.FS.60329939
WA
Other
Enumeration date
07/15/2014
Last updated
02/10/2015
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