| NPI | 1336292796 |
|---|---|
| Other Name | NW DERM AND SKIN CANCER CLC |
| Entity Type | Organization |
| Authorized Contact | JOHN LAWRENCE HEADLEY Owner 425-774-2616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA 600 551-763) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2008-06-25 |