| NPI | 1417163635 |
|---|---|
| Doing Business As | PACIFIC DERMATOLOGY AND COSMETIC CENTER |
| Doing Business As | PACIFIC DERMATOLOGY SURGERY CENTER |
| Doing Business As | FRONTIER DERMATOLOGY |
| Former Legal Business Name | REICHEL DERMATOLOGY ASSOCIATES, PLLC |
| Entity Type | Organization |
| Authorized Contact | MALISSA KOBBEVIK Credentialing Manager 360-375-2038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA md00042289) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2024-10-17 |