| NPI | 1649379231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE A JENNINGS Office Manager 425-454-1104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology |
| 207NP0225X Dermatology Pediatric Dermatology | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |