Active NPI
Baxter Plastic Surgery
- Ambulatory Surgical Clinic/Center
- Mountlake Terrace, WA
National Provider Identifier
1174076210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- MD00022150
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D2177705 | Baxter Plastic Surgery | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.