Organization Active NPI

Dermatology Associates PLLC

  • Dermatology Physician
  • Seattle, WA
National Provider Identifier
1376551002
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY ASSOCIATES PLLC
Practice address
1730 Minor Avenue
Ste 1000 Dermatology Associates PLLC
Seattle, WA 98101-1498
Phone
(206) 267-2100
Fax
(206) 267-2101
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Dr. Bernard Saul Goffe, MDNPI 1336157056
Title
Medical Director
Phone
(206) 267-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1730 Minor Avenue
Ste 1000 Dermatology Associates PLLC
Seattle, WA 98101-1498

Mailing address

1730 Minor Avenue
Ste 1000 Dermatology Associates PLLC
Seattle, WA 98101-1498
Phone (206) 267-2100

Other identifiers 1

IdentifierTypeStateIssuer
7122237MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1376551002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 MINOR AVENUE",
            "address_2": "STE 1000 DERMATOLOGY ASSOCIATES PLLC",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011498",
            "telephone_number": "206-267-2100",
            "fax_number": "206-267-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 MINOR AVENUE",
            "address_2": "STE 1000 DERMATOLOGY ASSOCIATES PLLC",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011498",
            "telephone_number": "206-267-2100",
            "fax_number": "206-267-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "GOFFE",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "SAUL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "206-267-2100",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7122237",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.