Dermatology & Allergy Specialists

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

DERMATOLOGY & ALLERGY SPECIALISTS

Practice address

304 W Bay Dr NW
Suite 301
Olympia, WA 98502-4958

Phone

(360) 413-8760

Fax

(360) 413-8839

NPI assigned

Jul 28, 2005

Last updated

Oct 22, 2013By 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

J. Mark Bauer, MD

Title

Partner

Phone

(360) 413-8297

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dermatology & Allergy Specialists of Olympia Other name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 11

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.

• Linda L Brown, M.D.

  • Allergy Physician
  • Tacoma, WA
  • NPI 1508830126
  Medicare reassignment Care Compare group NPD
• Kaley Myer, M.D.

  • Dermatology Physician
  • Olympia, WA
  • NPI 1164869459
  Medicare reassignment Care Compare group NPD
• Jacob Howard Bauer, M.D.

  • MOHS-Micrographic Surgery Physician
  • Olympia, WA
  • NPI 1407029762
  Medicare reassignment Care Compare group
• Andrea Cigliola, PA-C

  • Physician Assistant
  • Olympia, WA
  • NPI 1851819460
  Medicare reassignment Care Compare group
• Sarra Vashchenko, PA-C

  • Physician Assistant
  • Olympia, WA
  • NPI 1831199157
  Medicare reassignment Care Compare group
• Jennifer E Winter, PA-C

  • Physician Assistant
  • Olympia, WA
  • NPI 1740280056
  Medicare reassignment Care Compare group
• Katy L McCleery, D.O.

  • Dermatology Physician
  • Joint Base Lewis McChord, WA
  • NPI 1073965851
  Medicare reassignment NPD
• Shauna M Richert, MD

  • Dermatology Physician
  • Olympia, WA
  • NPI 1154321453
  Medicare reassignment NPD
• Samantha Ferguson, PA-C

  • Physician Assistant
  • Olympia, WA
  • NPI 1104224047
  Medicare reassignment
• Sukanya Kanthawatana, MD

  • Allergy & Immunology Physician
  • Olympia, WA
  • NPI 1447250741
  Medicare reassignment
• Callie Barnett

  • Medical Physician Assistant
  • Olympia, WA
  • NPI 1154239853
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382400000000",
    "number": "1497755797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W BAY DR NW",
            "address_2": "SUITE 301",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024953",
            "telephone_number": "360-413-8760",
            "fax_number": "360-413-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W BAY DR NW",
            "address_2": "SUITE 301",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024958",
            "telephone_number": "360-413-8760",
            "fax_number": "360-413-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & ALLERGY SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2013-10-22",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "360-413-8297",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GAB20350",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7105927",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology & Allergy Specialists of Olympia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Susan L Dennie, ARNP
• Annelise Denning, RDH, LMT
• Frauke Christa Depetter, LMT
• Gary Depriest, PA-C
• Derma PLLC (Derma Medical Spa)
• Derrick Family Chiropractic, Inc.
• Mitchell Eugene Derrick, D.C.
• Laurie E Deschenes
• Sarah Rubin Destasio
• Madelyn Joan Dethlefs

• Specialist in Olympia, WA
• Providers in Olympia, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.