Provider Demographics
NPI:1851324115
Name:JOHN R STREIDL, MD, PLLC
Entity Type:Organization
Organization Name:JOHN R STREIDL, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:STREIDL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-485-7985
Mailing Address - Street 1:17000 140TH AVE NE
Mailing Address - Street 2:UNIT 206
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072
Mailing Address - Country:US
Mailing Address - Phone:425-485-7985
Mailing Address - Fax:425-483-8135
Practice Address - Street 1:22833 BOTHELL EVERETT HIGHWAY
Practice Address - Street 2:C/O DERMSERVICE, SUITE 201
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021
Practice Address - Country:US
Practice Address - Phone:425-486-2340
Practice Address - Fax:425-483-8135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039710207N00000X, 207ND0900X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Not Answered207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty
Not Answered207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty