Provider Demographics
NPI:1336409705
Name:ACCENT DERMATOLOGY AND LASER INSTITUTE, PLLC
Entity Type:Organization
Organization Name:ACCENT DERMATOLOGY AND LASER INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:YUMI
Authorized Official - Last Name:SAWADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-463-9600
Mailing Address - Street 1:400 INDIANA ST
Mailing Address - Street 2:SUITE #390
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5027
Mailing Address - Country:US
Mailing Address - Phone:303-463-9600
Mailing Address - Fax:303-403-9919
Practice Address - Street 1:400 INDIANA ST
Practice Address - Street 2:SUITE #390
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5027
Practice Address - Country:US
Practice Address - Phone:303-463-9600
Practice Address - Fax:303-403-9919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-20
Last Update Date:2012-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25124207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty