OrganizationActive
Pacific Surgical Weight Loss Center, PLLC
NPI 1730456971 · Specialist · Olympia, WA
Provider details
- NPI number
- 1730456971
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Jackie Henderson, Insurance Staff(360) 412-3120
- License
- MD00036124 (WA)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
200 Lilly Rd Ne
Ste. C-2
Olympia, WA 98506
Phone: (360) 412-3120
Fax: (360) 412-1046
Street-level locationGet directions
Mailing address
200 Lilly Rd Ne
Olympia, WA 98506-5427
Other names (DBA / former)
- Doing business as
- Pacific Surgical Weight Loss Center, PLLC
Registry dates
- Enumerated
- 2011-11-16
- Last updated
- 2011-11-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.