Individual
MRS. TAJ MAHALIA ROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
12303 NE 130 LN, #330 EVERGREEN DERMATOLOGY CENTER, KIRKLAND, WA 98034
(425) 899-4300
(425) 899-4305
Mailing address
9710 5TH AVE NE, #201, SEATTLE, WA 98115
(206) 604-0160
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
3125
AK
207N00000X
Dermatology Physician
Primary
MD00029104
WA
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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