Organization
DERMATOLOGY & ALLERGY SPECIALISTS
Active
Other names
Dermatology & Allergy Specialists of Olympia
Organization subpart
No
Provider details
NPI number
Authorized official
J. MARK BAUER MD (PARTNER)
(360) 413-8297
Entity
Organization
Contact information
Practice address
304 W BAY DR NW, SUITE 301, OLYMPIA, WA 98502-4958
(360) 413-8760
(360) 413-8839
Mailing address
304 W BAY DR NW, SUITE 301, OLYMPIA, WA 98502-4953
(360) 413-8760
(360) 413-8839
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7105927
—
WA
01
—
GAB20350
MEDICARE
WA
Enumeration date
07/28/2005
Last updated
10/22/2013
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