| Custom Content | Return to Approve Applications Page | ||||||||||
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| Medspa Center Information | Please provide information about one location only. | ||||||||||
| Medspa Name | Maeve's MedSpa | ||||||||||
| Medspa Address | 3745 SW Southern Street Seattle, Washington 98126 United States Map It | ||||||||||
| Medspa Email Address | Email hidden; Javascript is required. | ||||||||||
| MedSpa Phone | (206) 370-1633 | ||||||||||
| Website URL | |||||||||||
| Manager Information | |||||||||||
| Manager Name | Maeve Post | ||||||||||
| Manager Email | Email hidden; Javascript is required. | ||||||||||
| Manager Cell Phone | (120) 637-0163 | ||||||||||
| ParentApplicationID | 260ec7f67196 | ||||||||||
| Medical Director for this Location | |||||||||||
| Add New Medical Director |
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| Medical Director Information | |||||||||||
| Medical Director Name | Bellamy Post | ||||||||||
| Medical Director Email | Email hidden; Javascript is required. | ||||||||||
| Medical School (or Nursing School if Nurse Practitioner) | Mayble's Med School | ||||||||||
| Degree | PHD | ||||||||||
| Primary Practice Name | |||||||||||
| Primary Practice Phone | |||||||||||
| NPI # | 1234567890 | ||||||||||
| License Number | 135789465 | ||||||||||
| License State | Washington Map It | ||||||||||
| Staff Information | |||||||||||
| How many service providers work at the location? | 1 | ||||||||||
| Service Provider Information |
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| Services |
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| Other | |||||||||||
| Products used in Patient Services |
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| Other | |||||||||||
| List main vendors for medical supplies |
