NPIMap

Organization Active NPI

Avalon Clinic

  • Clinic/Center
  • Lakewood, WA
National Provider Identifier
1073726360
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MD00046009 Issued in WA
Legal business name
AVALON CLINIC
Practice address
9315 Gravelly Lake Dr SW
Suite 103
Lakewood, WA 98499-1574
Phone
(253) 582-8486
Fax
(253) 582-2644
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Myles Goldflies, M.D.
Title
Plastic Surgeon
Phone
(253) 582-8486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD00046009 WA Primary

Addresses

Primary practice location

9315 Gravelly Lake Dr SW
Suite 103
Lakewood, WA 98499-1574

Mailing address

9315 Gravelly Lake Dr SW
Suite 103
Lakewood, WA 98499-1574
Phone (253) 582-8486

National Provider Directory

National Provider Directory
Tax ID family
Avalon Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9315 Gravelly Lake Dr SW
Ste 103
Lakewood, WA 98499
Phone (253) 582-8486

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073726360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9315 GRAVELLY LAKE DR SW",
            "address_2": "SUITE 103",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991574",
            "telephone_number": "253-582-8486",
            "fax_number": "253-582-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9315 GRAVELLY LAKE DR SW",
            "address_2": "SUITE 103",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991574",
            "telephone_number": "253-582-8486",
            "fax_number": "253-582-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDFLIES",
        "authorized_official_first_name": "MYLES",
        "authorized_official_title_or_position": "PLASTIC SURGEON",
        "authorized_official_telephone_number": "253-582-8486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "MD00046009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.