Organization
ATOMIC DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI HAINES DCNP (OWNER)
(509) 301-6451
Entity
Organization
Contact information
Practice address
9221 SANDIFUR PKWY STE A, PASCO, WA 99301-9241
(509) 233-7546
(509) 795-3508
Mailing address
7224 SANDY RIDGE RD, PASCO, WA 99301-9379
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60211812
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2089475
—
WA
Enumeration date
08/22/2017
Last updated
01/09/2023
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