The Gallery of Cosmetic Surgery

Primary specialty

SpecialistTaxonomy code 174400000X

License

43154 Issued in WA

Legal business name

THE GALLERY OF COSMETIC SURGERY

Practice address

3500 188TH St SW
Suite 670
Lynnwood, WA 98037-4716

Phone

(425) 775-3561

Fax

(425) 672-1385

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Dyanne K Middaugh

Title

Practice Manager

Phone

(425) 775-3561

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Practitioners 1

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

• Craig Ronald Jonov, DMD, MD

  • Oral and Maxillofacial Pathology Dentistry
  • Seattle, WA
  • NPI 1235134511

  Specialist

  NPD (past)

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861606162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 188TH ST SW",
            "address_2": "SUITE 670",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374716",
            "telephone_number": "425-775-3561",
            "fax_number": "425-672-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 188TH ST SW",
            "address_2": "SUITE 670",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374716",
            "telephone_number": "425-775-3561",
            "fax_number": "425-672-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GALLERY OF COSMETIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIDDAUGH",
        "authorized_official_first_name": "DYANNE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "425-775-3561"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "43154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassahun M Tessema
• Diwakar Thapa, PHARM D.
• The Bartell Drug Co
• The Bartell Drug Co
• The Center for Neurodiversity, LLC
• Theodore M Hennessey DDS PS
• Therapeutic Associates Inc
• Therapeutic Bodyworks
• Therapy Management Services, PLLC
• Therapy Management Services, PLLC

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

• 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.
• 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.