ATHENIX PHYSICIANS GROUP NORTHWEST, PLLC


Address: 636 120th Ave Ne Ste 202, Bellevue, WA 98005-3028
Phone: 4254542410

ATHENIX PHYSICIANS GROUP NORTHWEST, PLLC (NPI# 1801203310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801203310
Entity Type Organization
Organization Name ATHENIX PHYSICIANS GROUP NORTHWEST, PLLC
Other Organization Name ATHENIX BODY SCULPTING INSTITUTE
Practice Address 636 120th Ave Ne Ste 202
Bellevue
WA 98005-3028
Practice Telephone 4254542410
Practice Fax Number 4254542259
Mailing Telephone 4254542410
Mailing Fax Number 4254542259
Enumeration Date 2014-07-16
Last Update Date 2014-07-16
Authorized Official Name MR. JAMES HAEFNER (ADMINISTRATION)
Authorized Official Telephone 9496009931
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0122X Surgery
Specialization: Plastic and Reconstructive Surgery
MD 60033065 WA Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Athenix Body Sculpting Institute Doing Business As Name - Organization

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations ATHENIX PHYSICIANS GROUP NORTHWEST, PLLC 636 120th Ave Ne, Suite A202, Bellevue, WA 98005-3028

Office Location

Street Address 636 120TH AVE NE STE 202
City BELLEVUE
State WA
Zip Code 98005-3028

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578970117 Northwest Surgical Development of Bellevue LLC Clinic/Center 636 120th Ave Ne Ste 202, Bellevue, WA 98005-3028 2014-07-15

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679194161 Move Well, Be Well Pllc Clinic/Center 11900 Ne 1st Street, Suite 3106, Bellevue, WA 98005 2020-05-06
1649899410 Wen-fang Ku Acupuncturist 13555 Bel-red Rd, Suite 110, Bellevue, WA 98005 2020-04-13
1558901801 Janelle Morris Behavior Technician 12729 Northup Way, Suite 9, Bellevue, WA 98005 2020-01-14
1912467234 Amanda Gallardo Behavior Technician 13333 Bel Rd Suite 100, Bellevue, WA 98005 2019-03-22
1639637903 Oxana I Varvaryuk Massage Therapist 606 120th Ave Ne, Suite D104, Bellevue, WA 98005 2019-03-06
1609346246 Bhavjit Kaur Mangat Optometrist 1808 Richards Rd Suite 110, Bellevue, WA 98005 2018-11-27
1386138907 Amanda Frances Ellis Dietitian, Registered 915 118th Ave Se, Attention Alecia Johnson, Ret Physica, Suite 110, Bellevue, WA 98005 2018-06-18
1093227654 Jinda Chaijinda Naturopath 13353 Bel-red Road Suite A105, Bellevue, WA 98005 2017-11-03
1962927038 Laura Jo Zuker Olsen Optometrist 13401 Bel-red Rd Ne, Suite A4 - Bellevue Vision Clinic, Bellevue, WA 98005 2017-08-09
1336678697 Yong Huang Massage Therapist 12505 Bel-red Road, Suite 188, Bellevue, WA 98005 2017-06-08
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Taxonomy Information

Taxonomy Code 2086S0122X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Plastic and Reconstructive Surgery

Taxonomy Definition

A surgeon who specializes in plastic and reconstructive surgery.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164801189 Rikesh T. Parikh Md Pllc Surgery 1810 116th Ave Ne, Suite 102, Bellevue, WA 98004-3058 2015-05-22
1750538450 Rikesh Terence Parikh Surgery 1810 116th Ave Ne, Suite 102, Bellevue, WA 98004-3058 2008-08-25
1972712644 Sepehr Egrari Surgery 2950 Northup Way, Suite 100, Bellevue, WA 98004 2007-05-21
1811109994 Michael Leff Md Surgery 1600 116th Ave Ne, Sui, Bellevue, WA 98004-3014 2007-05-03
1831232834 Fredric Arlen Stern Surgery 1370 116th Ave Ne, Ste. 102, Bellevue, WA 98004-3825 2007-02-15

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1982079927 John Richard Alger Surgery 2323 Crystal Springs Rd W, University Place, WA 98466-2822 2015-12-02
1558752741 Cole Aesthetic Center Surgery 9800 Levin Rd Nw Ste 101, Silverdale, WA 98383-7849 2015-02-10
1730524596 Christopher Michael Bates Surgery 31852 Pacific Coast Hwy Suite 401, Laguna Beach, WA 92651 2013-05-07
1538401534 Sattler Plastic Surgery Surgery 6100 219th St Sw Ste 290, Mountlake Terrace, WA 98043-2222 2013-03-18
1265744585 Thomas D Gant Surgery 9006 Ne 116th Pl, Kirkland, WA 98034-6115 2010-07-02
1497928691 Gabriel Plastic Surgery, Ps Surgery 505 Ne 87th Ave Ste 250, Vancouver, WA 98664-1965 2008-04-08
1255481446 John Anthony Adams Surgery 530 S Cowley St Ste 180, Spokane, WA 99202-1316 2007-01-11
1821154790 Alexander Gougoutas Surgery 1560 N 115th St Ste 206, Seattle, WA 98133-8414 2006-12-28
1972694743 Brian H. Windle Surgery 7630 115th Pl Ne, Kirkland, WA 98033-6737 2006-09-27
1417931007 Todd Michael Willcox Surgery 11311 Bridgeport Way Sw Ste 309, Lakewood, WA 98499-3078 2005-12-06
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Competitor

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City BELLEVUE
Zip Code 98005

Improve Information

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Dataset Information

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.

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