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Organization

DERMATOPATHOLOTY NORTHWEST PLLC

Active
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Organization

DERMATOPATHOLOTY NORTHWEST PLLC

Active
Other names
Carlsen Histopath
Organization subpart
No

Provider details

NPI number
Authorized official
STACEY P MURDOCH (OFFICE MANAGER)
(425) 455-9945
Entity
Organization

Contact information

Practice address
2330 130TH AVE NE # 201, BELLEVUE, WA 98005-1756
(425) 455-9945
(425) 455-9947
Mailing address
2330 130TH AVE NE # 201, BELLEVUE, WA 98005-1756
(425) 455-9945
(425) 455-9947

Taxonomy

Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
50D0629327
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6337DE
REGENCE
WA
05
7099864
WA
Enumeration date
10/09/2006
Last updated
08/19/2008
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