Cleopatra Rejuvenation Clinic, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CLEOPATRA REJUVENATION CLINIC, PLLC

Practice address

17600 Talbot Rd S
Suite 5
Renton, WA 98055-5788

Phone

(425) 207-1398

NPI assigned

Aug 4, 2015

Organization subpart

No

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

Authorized official

Name

Emad Girgis, MD

Title

MD

Phone

(425) 207-1398

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ellen Lorraine Martin, ARNP, FNP-BC

  • Family Nurse Practitioner
  • Lakewood, WA
  • NPI 1538685110
  NPD (past)
• Kimberly A Forsti, PA-C

  • Physician Assistant
  • Estero, FL
  • NPI 1285955468
  NPD (past)

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1538545348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17600 TALBOT RD S",
            "address_2": "SUITE 5",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555788",
            "telephone_number": "425-207-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17600 TALBOT RD S",
            "address_2": "SUITE 5",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555788",
            "telephone_number": "425-207-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEOPATRA REJUVENATION CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "GIRGIS",
        "authorized_official_first_name": "EMAD",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "425-207-1398",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Jeffrey Clark, D.C.
• Richard D Clarke, CRNA
• Classic Cabulance LLC
• Clearly Lasik, Inc.
• Margaret H Clements, MD
• Seth Clewley
• Joseph Christopher Clifton, PHARM.D.
• Gary Don Cline, PAC
• Close Knit Counseling, PLLC
• Cloudland Home Care LLC

• Specialist in Renton, WA
• Providers in Renton, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.