| NPI | 1851324115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R STREIDL Owner 425-485-7985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA md00039710) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: WA MD00039710) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: WA md00039710) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |