Organization
EPIPHANY DERMATOLOGY OF WASHINGTON PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (EXECUTIVE DIRECTOR)
(512) 628-0465
Entity
Organization
Contact information
Practice address
7707 SE 27TH ST STE 104, MERCER ISLAND, WA 98040-2844
(512) 628-0465
Mailing address
7300 RANCH ROAD 2222, BLDG 1, STE 200, AUSTIN, TX 78730-3255
(512) 628-0465
(512) 233-2711
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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