Provider Demographics
NPI:1285180141
Name:SPECTRUM DERMATOLOGY OF SEATTLE PLLC
Entity Type:Organization
Organization Name:SPECTRUM DERMATOLOGY OF SEATTLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-707-9299
Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:STE 701
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-707-9299
Mailing Address - Fax:206-432-4552
Practice Address - Street 1:805 MADISON ST
Practice Address - Street 2:STE 701
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1172
Practice Address - Country:US
Practice Address - Phone:206-707-9299
Practice Address - Fax:206-432-4552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty