Provider Demographics
NPI:1548426885
Name:NORTH SOUND DERMATOLOGY P.C., INC.
Entity Type:Organization
Organization Name:NORTH SOUND DERMATOLOGY P.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DIETER
Authorized Official - Middle Name:KURT THOMAS
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-385-2009
Mailing Address - Street 1:15906 MILL CREEK BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1234
Mailing Address - Country:US
Mailing Address - Phone:425-385-2009
Mailing Address - Fax:425-939-0807
Practice Address - Street 1:15906 MILL CREEK BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1234
Practice Address - Country:US
Practice Address - Phone:425-385-2009
Practice Address - Fax:425-939-0807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044310207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty