SURGICAL WEIGHT LOSS CLINIC PLLC (NPI# 1811015399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1811015399 |
Entity Type | Organization |
Organization Name | SURGICAL WEIGHT LOSS CLINIC PLLC |
Practice Address |
3716 Pacific Ave Suite B Tacoma WA 98418-7836 |
Practice Telephone | 2534729850 |
Mailing Telephone | 2534729850 |
Enumeration Date | 2007-03-26 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. SAMUEL ROSS FOX (OWNER & SURGEON) |
Authorized Official Telephone | 2534729850 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
MD0002094 | WA | Ambulatory Health Care Facilities |
N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
MD00005293 | WA | Ambulatory Health Care Facilities |
Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
========= | WA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | NPI FOR SAMUEL ROSS FOX | 1942363353 | 01 |
WA | 7124175 | 05 | |
WA | DSHS FOR SAMUEL ROSS FOX | 8178618 | 01 |
WA | NPI FOR EARL ROSS FOX | 1306919725 | 01 |
WA | DSHS FOR EARL ROSS FOX | 1016468 | 01 |
Street Address |
3716 PACIFIC AVE SUITE B |
City | TACOMA |
State | WA |
Zip Code | 98418-7836 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780604009 | Living & Wellness Centers Ps | Physical Medicine & Rehabilitation | 3716 Pacific Ave, #e, Tacoma, WA 98418 | 2006-07-20 |
1578008363 | Yu Ri Cho | Denturist | 3716 Pacific Ave, Suite H, Tacoma, WA 98418-7836 | 2017-01-03 |
1699163048 | Float Capital Funding Corporation | Non-Pharmacy Dispensing Site | 3716 Pacific Ave, Suite H, Tacoma, WA 98418-7836 | 2015-01-07 |
1316351125 | K. Victoria Modica, N.d., Pllc | Non-Pharmacy Dispensing Site | 3716 Pacific Ave, Suite H, Tacoma, WA 98418-7836 | 2014-06-19 |
1649562695 | Medicinal Alternative Solutions, LLC | Clinical Nurse Specialist | 3716 Pacific Ave, Suite H, Tacoma, WA 98418-7836 | 2011-05-10 |
1558409441 | Fernando Francisco Deguzman | Family Medicine | 3716 Pacific Ave, Suite D, Tacoma, WA 98418-7836 | 2007-02-02 |
1831267251 | Paul Alexander | Massage Therapist | 3716 Pacific Ave, Ste E, Tacoma, WA 98418-7836 | 2006-12-01 |
1306919725 | Earl Ross Fox | Surgery | 3716 Pacific Ave, Suite B, Tacoma, WA 98418 | 2006-11-15 |
1295812501 | Scott Leslie Havsy | Physical Medicine & Rehabilitation | 3716 Pacific Ave, Suite E, Tacoma, WA 98418-7836 | 2006-11-01 |
1255433132 | Felino Bautista Deleon IIi | General Practice | 3716 Pacific Ave, Suite #d, Tacoma, WA 98418 | 2006-09-02 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083240287 | Zindt Chiropractic Center Pllc | Chiropractor | 3819 S. M St., Tacoma, WA 98418 | 2020-03-19 |
1649756792 | Jaime Armenta | Counselor | Tacoma-pierce County Health Department, 3629 South D Street, Tacoma, WA 98418 | 2018-07-12 |
1407166655 | Wjm Dental Inc | Dentist | 4002 South M Street, Suite A, Tacoma, WA 98418 | 2010-10-20 |
1255453890 | Stephen Joseph Bauml | Chiropractor | 212 So 37th St, Tacoma, WA 98418 | 2007-04-04 |
1710015912 | Lincoln Pharmacy LLC | Pharmacy | 821b S 38th St, Tacoma, WA 98418 | 2007-03-01 |
1104961093 | Still Well Chiropractic Clinic Inc | Chiropractor | 4537 S Yakima, Tacoma, WA 98418 | 2007-02-20 |
1497813851 | Penelope S. Zindt | Chiropractor | 3819 So M, Tacoma, WA 98418 | 2006-12-05 |
1902987092 | Donna Leigh Daeschner | Dentist | 4001 So. Yakima Avenue, Tacoma, WA 98418 | 2006-10-17 |
1083622971 | Willie James Mccullum | Dentist | 4002 South 'm' Street, Suite A, Tacoma, WA 98418 | 2006-08-04 |
1871500322 | Michelle Gray Marconi | Chiropractor | 4537 So. Yakima Ave, Tacoma, WA 98418 | 2006-08-01 |
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Taxonomy Code | 261QM2500X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Medical Specialty |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
Notes: [7/1/2003: new] |
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1538308143 | Chris Nichols Md Ps | Clinic/Center | 6002 Westgate Blvd Ste 160, Tacoma, WA 98406-2571 | 2009-02-05 |
1033277694 | Mt Rainier Surgical Associates | Clinic/Center | 419 S L St Ste 101, Tacoma, WA 98405-3799 | 2006-12-05 |
1295334555 | Mary K. Simonson, Md Pllc | Clinic/Center | 4041 Ruston Way Ste 202, Tacoma, WA 98402-5300 | 2020-10-19 |
1194083956 | Paul Andrew Sueno Md Pllc | Clinic/Center | 2411 S 19th St, Tacoma, WA 98405-2954 | 2012-04-30 |
1982871950 | Artistic Plastic Surgery Center Pllc | Clinic/Center | 3515 S 15th St, Suite #101, Tacoma, WA 98405-1952 | 2008-05-09 |
1144408840 | Ronald J Graf Md Ps | Clinic/Center | 1901 S Cedar St, #205, Tacoma, WA 98405-2308 | 2008-02-05 |
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1619592946 | Inner Vitality Pllc | Clinic/Center | 11711 Ne 12th St Ste 1a, Bellevue, WA 98005-2461 | 2020-06-12 |
1578057337 | Regenerative Medicine Northwest | Clinic/Center | 1260 116th Ave Ne Ste 200, Bellevue, WA 98004-3800 | 2018-06-15 |
1275052458 | Peninsula Spine Institute, Ps | Clinic/Center | 804 Callahan Dr Ste A, Bremerton, WA 98310-3307 | 2017-09-19 |
1477097251 | Cynthia D Gray Md PC | Clinic/Center | 2101 Ne 139th St Ste 285, Vancouver, WA 98686-2326 | 2016-12-13 |
1811377484 | Knead To Heal, LLC | Clinic/Center | 2312 Rucker Ave, Everett, WA 98201-2723 | 2015-06-09 |
1699185348 | Duane Fredrick Hopp | Clinic/Center | 22612 126th Ave E, Graham, WA 98338-6725 | 2014-05-03 |
1689919292 | Poma Fertility, LLC | Clinic/Center | 12039 Ne 128th St Ste 110, Kirkland, WA 98034-3030 | 2012-12-07 |
1275888232 | Massage Mundo | Clinic/Center | 423 Eastlake Ave E, Seattle, WA 98109-5408 | 2012-07-16 |
1144536079 | 3-d Diagnostics, LLC | Clinic/Center | 2616 Yelm Hwy Se Ste A, Olympia, WA 98501-0800 | 2010-08-30 |
1588982060 | Assured Imaging Womens Wellness of Washington, LLC | Clinic/Center | 565 Andover Park W Ste 110, Tukwila, WA 98188-3357 | 2010-05-10 |
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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.