Organization
NW DERMATOLOGY & SKIN CANCER CLINIC
Active
Other names
NW DERM AND SKIN CANCER CLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LAWRENCE HEADLEY M.D. (OWNER)
(425) 774-2616
Entity
Organization
Contact information
Practice address
21600 HIGHWAY 99, SUITE 280, EDMONDS, WA 98026-8012
(425) 774-2616
(425) 774-2660
Mailing address
21600 HIGHWAY 99, SUITE 280, EDMONDS, WA 98026-8012
(425) 774-2616
(425) 774-2660
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
600 551-763
WA
Other
Enumeration date
01/19/2007
Last updated
06/25/2008
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