Harbor Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

HARBOR DERMATOLOGY PLLC

Doing business as

Harbor Dermatology

Practice address

7901 Skansie Ave Ste 200
Gig Harbor, WA 98335-8349

Phone

(253) 400-1202

Fax

(253) 400-1203

NPI assigned

Jan 7, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Michael Mark Nelson, MDNPI 1093765034

Title

Owner

Phone

(253) 400-1202

Specialties & licenses 1

Addresses

Other names 1

• Harbor Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00146

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Mark Nelson, M.D.

  • Dermatology Physician
  • Gig Harbor, WA
  • NPI 1093765034
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1376204719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 SKANSIE AVE STE 200",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983358349",
            "telephone_number": "253-400-1202",
            "fax_number": "253-400-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 SKANSIE AVE STE 200",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983358349",
            "telephone_number": "253-400-1202",
            "fax_number": "253-400-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-400-1202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Renee Harbaugh, LD
• Harbor ABA
• Harbor Audiology & Hearing Services Inc
• Harbor Child and Family Therapy, PLLC
• Harbor Children's Therapy, L.L.C.
• Harbor Endoscopy Center Inc
• Harbor Eye Consultants
• Harbor Eye Physicians & Surgeons, PC
• Harbor First Assist Group, LLC
• Harbor Healing Arts PLLC (Habor Healing Arts)

• Dermatology Physician in Gig Harbor, WA
• Providers in Gig 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 Jan 7, 2022; 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.