Organization
NORTHWEST PEDIATRIC DERMATOLOGY, PLLC
Active
Other names
Vivian Lombillo, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIVIAN LOMBILLO MD (PHYSICIAN/OWNER)
(360) 539-6141
Entity
Organization
Contact information
Practice address
703 LILLY RD NE STE 105, OLYMPIA, WA 98506-5191
(360) 539-6141
Mailing address
PO BOX 2314, OLYMPIA, WA 98507-2314
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD00046225
WA
207NP0225X
Pediatric Dermatology Physician
Primary
MD00046225
WA
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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