Organization
SILVER FALLS DERMATOLOGY, LLC
Active
Other names
Pacific Dermatology and Cosmetic Center, FRONTIER DERMATOLOGY, Reichel Dermatology Associates, PLLC, Pacific Dermatology Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MALISSA KOBBEVIK (CREDENTIALING MANAGER)
(360) 375-2038
Entity
Organization
Contact information
Practice address
11011 MERIDIAN AVE N, SUITE 102, SEATTLE, WA 98133-8967
(206) 859-5777
(206) 859-5776
Mailing address
PO BOX 741825, LOS ANGELES, CA 90074-1825
(206) 859-5777
(206) 859-5776
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
MD00042289
WA
Other
Enumeration date
05/15/2007
Last updated
10/17/2024
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