AESTHETICA CLINIQUE LLC (NPI# 1508824293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508824293 |
| Entity Type | Organization |
| Organization Name | AESTHETICA CLINIQUE LLC |
| Practice Address |
801 Pacific Ave Tacoma WA 98402-5209 |
| Practice Telephone | 2295892588 |
| Mailing Telephone | 2295892588 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2012-09-11 |
| Authorized Official Name | DR. LOUIS DAVID POTYONDY (MANAGING MEMBER) |
| Authorized Official Telephone | 2295892588 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | MD 60288108 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 569370029A | 05 | |
| GA | DOCTORS'S NPI | 1104884956 | 01 |
| Street Address |
801 PACIFIC AVE |
| City | TACOMA |
| State | WA |
| Zip Code | 98402-5209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563741 | Amirali Shakouripartovi | Surgery | 801 Pacific Ave, Tacoma, WA 98402-5209 | 2019-08-19 |
| 1104884956 | Louis David Potyondy | Plastic Surgery | 801 Pacific Ave, Tacoma, WA 98402-5209 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
| Find all providers in zip 98402 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023451317 | Sarah Layne Crandall | Plastic Surgery | 5005 Main St Ste 125, Tacoma, WA 98407-3177 | 2013-04-17 |
| 1700100401 | Thomas Judson Irish Jr. | Plastic Surgery | 602 North Yakima Avenue, Tacoma, WA 98403-2418 | 2010-03-24 |
| 1962703140 | Franciscan Medical Group | Plastic Surgery | 6002 Westgate Blvd, Ste 160, Tacoma, WA 98406-2570 | 2010-11-04 |
| 1831244839 | Mansour V Shirbacheh | Plastic Surgery | 1708 Yakima Ave, Ste 115, Tacoma, WA 98405-5307 | 2007-01-23 |
| 1457412017 | Artistic Plastic Surgery Center Pllc | Plastic Surgery | 3515 S 15th St, Suite 101, Tacoma, WA 98405-1952 | 2006-12-13 |
| 1659477610 | Christopher Mead Nichols | Plastic Surgery | 6002 Westgate Blvd, Suite 160, Tacoma, WA 98406-2570 | 2006-09-16 |
| 1164443024 | Artistic Plastic Surgery Center | Plastic Surgery | 3515 S 15th St, Suite 101, Tacoma, WA 98405-1952 | 2006-07-23 |
| 1437106283 | Roy Alfred Semlacher | Plastic Surgery | 419 S L St, Tacoma, WA 98405-3799 | 2006-05-27 |
| 1104884956 | Louis David Potyondy | Plastic Surgery | 801 Pacific Ave, Tacoma, WA 98402-5209 | 2006-05-02 |
| 1922077411 | Louis Edmond Walker | Plastic Surgery | Madigan Army Medical Center, 9040 Reid St., Attn: Mchj-qcr, Tacoma, WA 98431-0001 | 2006-03-16 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.