| NPI | 1598137820 |
|---|---|
| Doing Business As | DOHERTY DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | MARK J DOHERTY Owner 360-961-0843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD00020973) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD00020973) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2016-11-23 |