Family Dermatology Co

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FAMILY DERMATOLOGY CO

Practice address

275 SE Cabot Dr Ste A3
Oak Harbor, WA 98277-3740

Phone

(360) 682-5024

Fax

(360) 682-5749

NPI assigned

Sep 20, 2011

Last updated

Apr 1, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Reese Bliek, PA-CNPI 1811962442

Title

President

Phone

(360) 682-5024

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reese J Bliek, P.A.

  • Medical Physician Assistant
  • Oak Harbor, WA
  • NPI 1811962442
  Medicare reassignment Care Compare group Authorized official
• Susan Oldenkamp, M.D.

  • Dermatology Physician
  • Everett, WA
  • NPI 1275669459
  Medicare reassignment Care Compare group NPD
• Charles Anthony Frosolone, M.D.

  • Surgery Physician
  • NPI 1750351276

  WA

  Medicare reassignment Care Compare group NPD
• Timothy Arthur Graves, MD

  • Surgery Physician
  • Coupeville, WA
  • NPI 1467557728
  Medicare reassignment Care Compare group
• Collin Thomas Perri

  • Physician Assistant
  • Spokane, WA
  • NPI 1053996785
  Medicare reassignment Care Compare group
• Eryn Nicole Beaupre, FNP

  • Family Nurse Practitioner
  • Anacortes, WA
  • NPI 1588357438
  Medicare reassignment NPD
• John Thomas Hassapis, MD

  • Surgery Physician
  • Coupeville, WA
  • NPI 1992709802
  Medicare reassignment NPD
• Sarah C Owen, ARNP

  • Family Nurse Practitioner
  • Oak Harbor, WA
  • NPI 1154842680
  Medicare reassignment NPD
• Richard S Herdener, M.D.

  • Dermatology Physician
  • Spokane, WA
  • NPI 1457326365
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1275816910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SE CABOT DR STE A3",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773740",
            "telephone_number": "360-682-5024",
            "fax_number": "360-682-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SE CABOT DR STE A3",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773740",
            "telephone_number": "360-682-5024",
            "fax_number": "360-682-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DERMATOLOGY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "BLIEK",
        "authorized_official_first_name": "REESE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-682-5024",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI",
            "identifier": "603137655",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Marie Epp, FNP-C
• Travis Erickson, DO
• William Charles Eskridge, PHARMD
• Even Flow, LLC (Peterson Family Chiropractic)
• Family Care Health Information Network, Incorporated (A Plus Diabetic Supply)
• Family Foot and Ankle Care Incorporation
• Melissa Ethridge Farrell, RN
• Susan Farris, M.S., CCC-SLP
• Diana Fedele
• Kimberly Marie Ferguson, PA-C

• Dermatology Physician in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.