Organization
ISLAND COUNTY DERMATOLOGY PLLC
Active
Other names
WHIDBEY DERMATOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD RUSSELL JOHNSON M.D., PH.D. (OWNER, MEDICAL DIRECTOR)
(360) 678-6561
Entity
Organization
Contact information
Practice address
205 S MAIN ST, BLG A, COUPEVILLE, WA 98239-9500
(360) 678-6561
(360) 678-7133
Mailing address
PO BOX 900, COUPEVILLE, WA 98239-0900
(360) 678-6561
(360) 678-7133
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00038058
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1108877
—
WA
01
—
1598790990
NPI
WA
Enumeration date
08/10/2006
Last updated
09/28/2010
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