Island Facial Aesthetics P.S.
Nurse Practitioner in Coupeville, WA. Organization (NPI-2).
NPI number1164054961
StatusActive
Last updated in NPPESDec 18, 2020
Details
- NPI
- 1164054961
- Entity type
- Organization (NPI-2)
- Legal business name
- Island Facial Aesthetics P.S.
- Organization subpart
- No
- Enumeration date
- Feb 10, 2020
- Certification date
- Dec 18, 2020
- Last updated
- Dec 18, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Practice location
30 Nw Birch StCoupeville, WA 98239-3103
Phone 360-678-1515 · Fax 360-678-5037
Mailing address
30 Nw Birch StCoupeville, WA 98239-3103
Phone 360-678-1515 · Fax 360-678-5037
Authorized official
Kristy Anderson
Owner
3609690805
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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