| NPI | 1326074881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STELLA DESYATNIKOVA Owner 425-744-1760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: WA 602302730) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-08-22 |