ATHENIX BODY SCULPTING INSTITUTE
NPI 1578970117
Clinic/Center - Ambulatory Surgical in Bellevue, WA

Q: What is Northwest Surgical Development Of Bellevue LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Active since July 15, 2014CLIA 50D2039119 · Waiver

636 120TH AVE NE STE 202, BELLEVUE, WA 98005(425) 454-2410(425) 454-2259 Get Directions Write a Review

NPPES record last updated: February 10, 2015. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Athenix Body Sculpting Institute NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ATHENIX BODY SCULPTING INSTITUTE (NPI 1578970117) is a healthcare organization registered as an ambulatory surgical in Bellevue, Washington and active in the NPI registry since July 2014. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists James Haefner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1578970117

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameNORTHWEST SURGICAL DEVELOPMENT OF BELLEVUE LLC

Location Address636 120TH AVE NE STE 202Bellevue, WA 98005-3028

Mailing Address65 Enterprise Ste 125Aliso Viejo, CA 92656-2706 · (949) 600-9931 · Fax (949) 600-8029

Phone(425) 454-2410

Fax(425) 454-2259

Organization SubpartNo

Authorized OfficialJames HaefnerCeo · (949) 600-9931

Enumeration DateJuly 15, 2014

Last NPPES UpdateFebruary 10, 2015

✔ NPI 1578970117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

License✔ Licensed in WA · ASF.FS.60329939

636 120TH AVE NE STE 202, Bellevue, WA 98005

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Other Names 1

Doing Business AsAthenix Body Sculpting Institute

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2039119

Athenix Body Sculpting Institute · Bellevue, WA

Active · expires Apr 4, 2028

CLIA Number50D2039119

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateApril 2, 2012

Certificate Expiration DateApril 4, 2028

Laboratory DirectorGavin Dry

Laboratory Phone(425) 454-2410

Laboratory LocationAthenix Body Sculpting Institute636 120th Ave NE Ste 202, Bellevue, WA 98005

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ATHENIX PHYSICIANS GROUP NORTHWEST, PLLC

Surgery (Plastic and Reconstructive Surgery)

636 120TH AVE NE STE 202
BELLEVUE, WA 98005

King County (425) 454-2410

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northwest Surgical Development Of Bellevue LLC's NPI number?

The NPI number for Northwest Surgical Development Of Bellevue LLC is 1578970117. It was assigned to this organization in the NPPES registry on July 15, 2014. The provider is doing business as Athenix Body Sculpting Institute.

Where is Northwest Surgical Development Of Bellevue LLC located?

Northwest Surgical Development Of Bellevue LLC is located at 636 120th Ave NE Ste 202, Bellevue, WA 98005. The listed phone number is (425) 454-2410.

What is Northwest Surgical Development Of Bellevue LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Northwest Surgical Development Of Bellevue LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2039119) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northwest Surgical Development Of Bellevue LLC was last updated on February 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.