ISLAND COUNTY DERMATOLOGY PLLC (NPI# 1649281320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649281320 |
| Entity Type | Organization |
| Organization Name | ISLAND COUNTY DERMATOLOGY PLLC |
| Other Organization Name | WHIDBEY DERMATOLOGY |
| Practice Address |
205 S Main St Blg A Coupeville WA 98239-9500 |
| Mailing Address |
Po Box 900 Coupeville WA 98239-0900 |
| Practice Telephone | 3606786561 |
| Practice Fax Number | 3606787133 |
| Mailing Telephone | 3606786561 |
| Mailing Fax Number | 3606787133 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2010-09-28 |
| Authorized Official Name | DR. DONALD RUSSELL JOHNSON (OWNER, MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3606786561 |
| Authorized Official Credential | M.D., PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD00038058 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | NPI | 1598790990 | 01 |
| WA | 1108877 | 05 |
| Other Name | Type Code |
|---|---|
| WHIDBEY DERMATOLOGY | Doing Business As Name - Organization |
| Street Address |
205 S MAIN ST BLG A |
| City | COUPEVILLE |
| State | WA |
| Zip Code | 98239-9500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295012151 | Charles Wynkoop | Counselor | 105 N W 1st Street, Coupeville, WA 98239 | 2011-11-07 |
| 1740584598 | Justine Hagness | Counselor | 105 Northwest 1st Street, Coupeville, WA 98239 | 2011-01-07 |
| 1659674851 | Lindsay Rae Farish | Physical Therapist | 35 Nw 1st Street, Coupeville, WA 98239 | 2010-12-09 |
| 1144550526 | Lori B Taylor | Nutritionist | 107 South Main St., Suite D201, Coupeville, WA 98239 | 2010-01-06 |
| 1013155407 | Tana Louise Cornelius | Respiratory Therapist, Registered | 1143 Nimitz Dr, Coupeville, WA 98239 | 2009-01-23 |
| 1447413091 | Whidbey Island Public Hospital District | General Acute Care Hospital | 205 S Main Street, A, Coupeville, WA 98239 | 2008-07-03 |
| 1831375138 | Laura Ann Natusch | Marriage & Family Therapist | 604 Nw Glenwood Court, Coupeville, WA 98239 | 2008-01-16 |
| 1417139791 | Compass Health | Community/Behavioral Health | 105 Northwest First Street, Coupeville, WA 98239 | 2007-11-29 |
| 1972723724 | Stanley Norling Anderson | Dentist | 412 N. Main St., Coupeville, WA 98239 | 2007-04-26 |
| 1053476457 | Bj Solberg | Social Worker | 105 N. First St., Coupeville, WA 98239 | 2006-12-26 |
| Find all providers in zip 98239 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694864 | Fishers Landing Internal Medicine | Dermatology | 1405 Se 164th Ave Ste 101, Vancouver, WA 98683-9644 | 2020-06-23 |
| 1417599374 | Dermatology Solutions | Dermatology | 8503 W Clearwater Ave Ste B, Kennewick, WA 99336-3100 | 2019-10-11 |
| 1588164925 | Northwest Pediatric Dermatology, Pllc | Dermatology | 703 Lilly Rd Ne Ste 105, Olympia, WA 98506-5191 | 2018-02-12 |
| 1255858247 | Ame Phitwong | Dermatology | 21727 76th Ave W Ste H, Edmonds, WA 98026-7549 | 2017-08-29 |
| 1467879320 | Jayasri Iyer | Dermatology | 9924 Ne 185th St Ste 215, Bothell, WA 98011-3504 | 2014-03-27 |
| 1164869459 | Kaley Myer | Dermatology | 304 W Bay Dr Nw Ste 301, Olympia, WA 98502-4957 | 2013-05-28 |
| 1093158305 | Erica Shantha Tarabadkar | Dermatology | 850 Republican Street, Brotman Room 242, Uw Medical Center At Lake Union, Seattle, WA 98109 | 2013-04-17 |
| 1871835322 | Jason Lee Meeker | Dermatology | 2622 S. Meridian, Puyallup, WA 98373-1500 | 2013-03-22 |
| 1578839494 | Carolina Andrea Simunovic | Dermatology | 1959 Ne Pacific St Rm Bb-1353, Box 356524, Seattle, WA 98195-6524 | 2012-03-25 |
| 1184999260 | April Schachtel | Dermatology | 1660 S Columbian Way Va Puget Sound Health Care System, General Internal Medicine Clinic, Seattle, WA 98108 | 2012-03-21 |
| Find all providers with the same taxonomy | ||||
| City | COUPEVILLE |
| Zip Code | 98239 |
Please comment or provide details below to improve the information on ISLAND COUNTY DERMATOLOGY PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.