Provider Demographics
NPI:1881835171
Name:DERMAHEALTH DERMATOLOGY, PLLC
Entity Type:Organization
Organization Name:DERMAHEALTH DERMATOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-783-2004
Mailing Address - Street 1:1305 FOWLER STREET
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4715
Mailing Address - Country:US
Mailing Address - Phone:509-783-2004
Mailing Address - Fax:509-783-1949
Practice Address - Street 1:1305 FOWLER STREET
Practice Address - Street 2:SUITE 1C
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4715
Practice Address - Country:US
Practice Address - Phone:509-783-2004
Practice Address - Fax:509-783-1949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD0046007207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty