NORTHWEST SURGICAL DEVELOPMENT OF BELLEVUE LLC


Address: 636 120th Ave Ne Ste 202, Bellevue, WA 98005-3028
Phone: 4254542410

NORTHWEST SURGICAL DEVELOPMENT OF BELLEVUE LLC (NPI# 1578970117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578970117
Entity Type Organization
Organization Name NORTHWEST SURGICAL DEVELOPMENT OF BELLEVUE LLC
Other Organization Name ATHENIX BODY SCULPTING INSTITUTE
Practice Address 636 120th Ave Ne Ste 202
Bellevue
WA 98005-3028
Mailing Address 65 Enterprise Ste 125
Aliso Viejo
CA 92656-2706
Practice Telephone 4254542410
Practice Fax Number 4254542259
Mailing Telephone 9496009931
Mailing Fax Number 9496008029
Enumeration Date 2014-07-15
Last Update Date 2015-02-10
Authorized Official Name MR. JAMES HAEFNER (CEO)
Authorized Official Telephone 9496009931
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
ASF.FS.60329939 WA Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Athenix Body Sculpting Institute Doing Business As Name - Organization

Office Location

Street Address 636 120TH AVE NE STE 202
City BELLEVUE
State WA
Zip Code 98005-3028

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801203310 Athenix Physicians Group Northwest, Pllc Surgery 636 120th Ave Ne Ste 202, Bellevue, WA 98005-3028 2014-07-16

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NPI Name Taxonomy Address Enumeration
1679194161 Move Well, Be Well Pllc Clinic/Center 11900 Ne 1st Street, Suite 3106, Bellevue, WA 98005 2020-05-06
1649899410 Wen-fang Ku Acupuncturist 13555 Bel-red Rd, Suite 110, Bellevue, WA 98005 2020-04-13
1558901801 Janelle Morris Behavior Technician 12729 Northup Way, Suite 9, Bellevue, WA 98005 2020-01-14
1912467234 Amanda Gallardo Behavior Technician 13333 Bel Rd Suite 100, Bellevue, WA 98005 2019-03-22
1639637903 Oxana I Varvaryuk Massage Therapist 606 120th Ave Ne, Suite D104, Bellevue, WA 98005 2019-03-06
1609346246 Bhavjit Kaur Mangat Optometrist 1808 Richards Rd Suite 110, Bellevue, WA 98005 2018-11-27
1386138907 Amanda Frances Ellis Dietitian, Registered 915 118th Ave Se, Attention Alecia Johnson, Ret Physica, Suite 110, Bellevue, WA 98005 2018-06-18
1093227654 Jinda Chaijinda Naturopath 13353 Bel-red Road Suite A105, Bellevue, WA 98005 2017-11-03
1962927038 Laura Jo Zuker Olsen Optometrist 13401 Bel-red Rd Ne, Suite A4 - Bellevue Vision Clinic, Bellevue, WA 98005 2017-08-09
1336678697 Yong Huang Massage Therapist 12505 Bel-red Road, Suite 188, Bellevue, WA 98005 2017-06-08
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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

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1265614523 Sam Naficy, Md, Ps, Inc Clinic/Center 1110 112th Ave Ne, Suite 150, Bellevue, WA 98004-4509 2007-11-28
1104931039 Bellegrove Ob/gyn, Inc. Ps Clinic/Center 1200 112th Ave Ne Ste C115, Bellevue, WA 98004-3745 2006-08-20
1992702443 The Eastside Endoscopy Center LLC Clinic/Center 1135 116th Ave Ne, Suite 570, Bellevue, WA 98004-4623 2005-06-30
1538769302 Spine Solutions of Green Bay LLC Clinic/Center 2595 Development Dr Ste 150, Bellevue, WI 54311-4288 2020-10-29
1982238465 Professional Recreation Organization, Inc. Clinic/Center 4455 148th Ave Ne, Bellevue, WA 98007-3120 2020-02-24
1144708819 Professional Recreation Organization, Inc. Clinic/Center 4455 148th Ave Ne, Bellevue, WA 98007-3120 2018-08-03
1366884835 Renaissance Center Clinic/Center 1414 116th Ave Ne Ste C, Bellevue, WA 98004-3801 2013-07-24
1699112144 Christine E Nygaard, M.d., P.s. Clinic/Center 1414 116th Ave Ne Ste C, Bellevue, WA 98004-3801 2013-05-23
1083955330 Bellevue Plastic Surgery Center Clinic/Center 10047 Main St, Suite 103, Bellevue, WA 98004-6019 2013-03-12
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Competitor

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City BELLEVUE
Zip Code 98005

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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