Organization
PACIFIC SURGICAL WEIGHT LOSS CENTER, PLLC
Active
Other names
Pacific Surgical Weight Loss Center, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACKIE HENDERSON (INSURANCE STAFF)
(360) 412-3120
Entity
Organization
Contact information
Practice address
200 LILLY RD NE, STE. C-2, OLYMPIA, WA 98506
(360) 412-3120
(360) 412-1046
Mailing address
200 LILLY RD NE, SUITE C-2, OLYMPIA, WA 98506-5427
(360) 412-3120
(360) 412-1046
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00036124
WA
Other
Enumeration date
11/16/2011
Last updated
11/16/2011
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