Organization
ISLAND DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETTY J HEUPEL (OFFICE MANAGER)
(425) 486-2340
Entity
Organization
Contact information
Practice address
8435 SE 68TH ST, STE 118, MERCER ISLAND, WA 98040
(206) 232-7546
(206) 275-0805
Mailing address
8435 SE 68TH ST, STE 118, MERCER ISLAND, WA 98040
(206) 232-7546
(206) 275-0805
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7105935
—
WA
Enumeration date
06/30/2006
Last updated
08/22/2020
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