Organization Name: | NORTHWEST VEIN & AESTHETIC CENTER |
NPI Number: | 1063729952 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AKSEL NORDESTGAARD (M.D.) |
Mailing Address: | 4700 Point Fosdick Dr Nw Ste 307 Gig Harbor |
State: | WA US |
Postal Code: | 983351706 |
Phone Number: | 2538578346 |
Fax Number: | |
NPI Enumeration Date: | 09/13/2010 |
NPI Last Update Date: | 09/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |