Pacific Northwest Plastic Surgery, Ps
NPI #1205951910 in University Place, Washington
Provider Information
- NPI Number
- 1205951910
- Entity Type
- Organization
- Organization Name
- Pacific Northwest Plastic Surgery, Ps
- Primary Specialty
- Specialist
- Enumeration Date
- Mar 20, 2007
- Last Updated
- Jan 18, 2012
Practice Location
- Address
- 5016 BRIDGEPORT WAY W
- Address 2
- SUITE A
- City
- University Place
- State
- Washington
- ZIP Code
- 98467-2039
- Phone
- (253) 761-9515
Authorized Official
- Name
- DR. ROSS MAGLAQUE REALICA, MD
- Title
- PRESIDENT
- Phone
- (253) 761-9515
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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