Pacific Surgical Weight Loss Center, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD00036124 Issued in WA

Legal business name

PACIFIC SURGICAL WEIGHT LOSS CENTER, PLLC

Practice address

200 Lilly Rd NE
Ste. C-2
Olympia, WA 98506

Phone

(360) 412-3120

Fax

(360) 412-1046

NPI assigned

Nov 16, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Jackie Henderson

Title

Insurance Staff

Phone

(360) 412-3120

Specialties & licenses 1

Addresses

Other names 1

• Pacific Surgical Weight Loss Center, PLLC Doing business as

Locations

Practitioners 2

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

• Kenneth David Klions, M.D.

  • Anesthesiology Physician
  • Bremerton, WA
  • NPI 1255321501
  NPD (past)
• Francisco Delacruz-Newlan, M.D.

  • Anesthesiology Physician
  • Quincy, IL
  • NPI 1922006451
  NPD (past)

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321401600000",
    "number": "1730456971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE",
            "address_2": "SUITE C-2",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065427",
            "telephone_number": "360-412-3120",
            "fax_number": "360-412-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE",
            "address_2": "STE. C-2",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-412-3120",
            "fax_number": "360-412-1046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC SURGICAL WEIGHT LOSS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "INSURANCE STAFF",
        "authorized_official_telephone_number": "360-412-3120",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00036124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Surgical Weight Loss Center, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pacific Medical, Inc.
• Pacific Northwest Dental Group, LLC
• Pacific Northwest Eye Care, PS
• Pacific Northwest Eye Care, PS
• Pacific Northwest Psychological Services and Consulting
• Nova Marie Paden, CPC
• Brittany Marie Padilla, LMP
• Scott Michael Padjen, LICSW
• Mi Ni Paek, PHARMD
• Paid for Passion

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.