| Botox In The Park | |
|
2800 E Madison St Ste 201 Seattle WA 98112-4865 | |
| (206) 717-5622 | |
| (949) 561-4815 |
| Full Name | Botox In The Park |
|---|---|
| Speciality | Clinic/Center |
| Location | 2800 E Madison St Ste 201, Seattle, Washington |
| Authorized Official Name and Position | Leslie Casias (OWNER/PROVIDER) |
| Authorized Official Contact | 2067175622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Botox In The Park 2800 E Madison St Ste 201 Seattle WA 98112-4865 Ph: (206) 717-5622 | Botox In The Park 2800 E Madison St Ste 201 Seattle WA 98112-4865 Ph: (206) 717-5622 |
| NPI Number | 1750019147 |
|---|---|
| Provider Enumeration Date | 08/12/2022 |
| Last Update Date | 07/26/2023 |
| Medicare PECOS PAC ID | 2264802354 |
|---|---|
| Medicare Enrollment ID | O20230106000453 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750019147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Leslie S Casias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699085308 PECOS PAC ID: 5698918951 Enrollment ID: I20150529002664 |
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