Organization Active NPI

Baxter Plastic Surgery

  • Ambulatory Surgical Clinic/Center
  • Mountlake Terrace, WA
National Provider Identifier
1174076210
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
MD00022150 Issued in WA
Legal business name
BAXTER PLASTIC SURGERY
Practice address
6100 219TH St SW
Suite 290
Mountlake Terrace, WA 98043-2222
Phone
(425) 776-0880
NPI assigned
Jul 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Authorized official

Name
Dr. Richard Alan Baxter, M.D.
Title
Owner
Phone
(425) 776-0880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X MD00022150 WA Primary

Addresses

Primary practice location

6100 219TH St SW
Suite 290
Mountlake Terrace, WA 98043-2222

Mailing address

6100 219TH St SW
Suite 290
Mountlake Terrace, WA 98043-2222
Phone (425) 776-0880

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2177705Baxter Plastic Surgery6100 219TH St SW Ste 290, Mountlake Terrace, WA 98043Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

6100 219th St SW
Ste 290
Mountlake Terrace, WA 98043
Phone (425) 775-0880

NPI Registry JSON

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1174076210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 219TH ST SW",
            "address_2": "SUITE 290",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432222",
            "telephone_number": "425-776-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 219TH ST SW",
            "address_2": "SUITE 290",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432222",
            "telephone_number": "425-776-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-776-0880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "MD00022150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.