# SILK DERMATOLOGY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649075987
- **Authorized official:** SHIVA NOROUZI (OWNER)
- **Authorized official phone:** (360) 836-0065

## Contact information

- **Practice address:** 6529 NE HIGHWAY 99, VANCOUVER, WA 98665-8719
- **Practice address phone:** (360) 836-0065
- **Practice address fax:** (360) 900-0488
- **Mailing address:** 6529 NE HIGHWAY 99, VANCOUVER, WA 98665-8719
- **Mailing address phone:** (360) 836-0065
- **Mailing address fax:** (360) 900-0488

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 02/18/2025
- **Last updated:** 06/10/2025