Individual
KEITH CAMERON CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11511 NE 10TH ST, BELLEVUE, WA 98004-8578
(425) 502-3000
Mailing address
11511 NE 10TH ST, BELLEVUE MEDICAL CENTER, BELLEVUE, WA 98004
(425) 502-3000
(425) 502-3589
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD60650552
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G501320
MEDICAL PPIN #
CA
Enumeration date
07/10/2006
Last updated
03/31/2021
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