Westside Dermatology, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

602335909 Issued in WA

Legal business name

WESTSIDE DERMATOLOGY, PLLC

Practice address

4740 44TH Ave SW
Suite 200
Seattle, WA 98116-4402

Phone

(206) 937-8954

Fax

(206) 937-1916

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Joseph R Erickson

Title

Manager

Phone

(206) 937-8954

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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

• Kelli Renae Arntzen, MD

  • Dermatology Physician
  • Seattle, WA
  • NPI 1477630051
  Medicare reassignment NPD
• Ramsey Fuad Markus, M.D.

  • Dermatology Physician
  • Houston, TX
  • NPI 1326130337

  WA

  Medicare reassignment NPD
• Taj Mahalia Rock, PHYSICIAN ASSISTANT

  • Dermatology Physician
  • Kirkland, WA
  • NPI 1801973219
  Medicare reassignment
• Elizabeth Jayne Keller Wood, MS, PA-C

  • Physician Assistant
  • Federal Way, WA
  • NPI 1376782763
  Medicare reassignment
• Tina Finesmith, MD

  • Specialist
  • Seattle, WA
  • NPI 1053498659
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1396862280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 44TH AVE SW",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164402",
            "telephone_number": "206-937-8954",
            "fax_number": "206-937-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 44TH AVE SW",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164402",
            "telephone_number": "206-937-8954",
            "fax_number": "206-937-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "206-937-8954"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WA",
            "license": "602335909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly R Westom, SUDP
• Gregory Maxwell Weston, M.D.
• Piper Weston
• Antonio Carlos Anderson Westphalen, M.D.
• Westside Chiropractic
• Westside Pharmacy
• Westside Smile Dental LLC
• Westwood Village Chiropractic, LLC
• Tamara Lynn Westwood, BS
• Michala C Wetherington, COTA

• Dermatology Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.