Organization
BODY BALANCE HEALTH AND AESTHETICS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZAMAT BERDIYEV (OPERATIONS MANAGER)
(360) 747-2000
Entity
Organization
Contact information
Practice address
1905 SE 192ND AVE STE 201, CAMAS, WA 98607-7415
(360) 747-2000
Mailing address
1905 SE 192ND AVE STE 201, CAMAS, WA 98607-7415
(360) 747-2000
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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