Derma PLLC

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

DERMA PLLC

Doing business as

Derma Medical Spa

Practice address

3025 Limited LN NW
Suite 100
Olympia, WA 98502-2613

Phone

(360) 350-5321

NPI assigned

Jun 30, 2016

Organization subpart

No

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

Authorized official

Name

Amanda Berg

Title

Spa Director

Phone

(360) 350-5321

Specialties & licenses 1

Addresses

Other names 1

• Derma Medical Spa Doing business as

Locations

Practitioners 1

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

• Haunani Dawn Atwood, LMT

  • Massage Therapist
  • Tumwater, WA
  • NPI 1447591011
  NPD (past)

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1548611569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 LIMITED LN NW",
            "address_2": "SUITE 100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985022613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 LIMITED LN NW",
            "address_2": "SUITE 100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985022613",
            "telephone_number": "360-350-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "SPA DIRECTOR",
        "authorized_official_telephone_number": "360-350-5321"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derma Medical Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stefanie Denney, HIS
• Susan L Dennie, ARNP
• Annelise Denning, RDH, LMT
• Frauke Christa Depetter, LMT
• Gary Depriest, PA-C
• Dermatology & Allergy Specialists
• Derrick Family Chiropractic, Inc.
• Mitchell Eugene Derrick, D.C.
• Laurie E Deschenes
• Sarah Rubin Destasio

• Public Health or Welfare Agency in Olympia, WA
• Providers in Olympia, WA by specialty
• Public Health or Welfare Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.