Organization
DERMATOLOGY ASSOCIATES OF SOUTHWEST WASHINGTON, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL H DATLOFF M.D. (OWNER)
(360) 254-5267
Entity
Organization
Contact information
Practice address
8614 E MILL PLAIN BLVD, SUITE 400, VANCOUVER, WA 98664-2059
(360) 254-5267
(360) 254-6089
Mailing address
8614 E MILL PLAIN BLVD, SUITE 400, VANCOUVER, WA 98664-2059
(360) 254-5267
(360) 254-6089
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7065758
—
WA
Enumeration date
08/25/2009
Last updated
05/31/2012
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