NPIMap

Organization Active NPI

Rosario Skin Clinic PC Inc

Doing business as Rosario Skin Cliniic

  • Medical Specialty Clinic/Center
  • Mount Vernon, WA
National Provider Identifier
1609813385
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
MD00046521 Issued in WA
Legal business name
ROSARIO SKIN CLINIC PC INC
Doing business as
Rosario Skin Cliniic
Practice address
1600 Continental Place
Suite #101
Mount Vernon, WA 98273-5607
Phone
(360) 336-3026
NPI assigned
Jun 1, 2006
Last updated
Jul 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Authorized official

Name
Krista Klelt, CMA
Title
Practice Manager
Phone
(360) 336-3026

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X MD00045767 WA
Medical Specialty Clinic/Center 261QM2500X MD00046521 WA Primary

Addresses

Primary practice location

1600 Continental Place
Suite #101
Mount Vernon, WA 98273-5607

Mailing address

1600 Continental Place
Suite #101
Mount Vernon, WA 98273-5607
Phone (360) 336-3026

Other names 1

  • Rosario Skin Cliniic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1059145Rosario Skin Clinic1600 Continental PL Ste 101, Mount Vernon, WA 98273ComplianceApr 4, 2028

National Provider Directory

National Provider Directory

Locations

1600 Continental Pl
Mount Vernon, WA 98273
Phone (360) 336-3026

1600 Continental Pl
Ste 10
Mount Vernon, WA 98273

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1609813385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CONTINENTAL PLACE",
            "address_2": "SUITE #101",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735607",
            "telephone_number": "360-336-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CONTINENTAL PLACE",
            "address_2": "SUITE #101",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735607",
            "telephone_number": "360-336-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSARIO SKIN CLINIC PC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "KLELT",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "360-336-3026",
        "authorized_official_credential": "CMA"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "MD00045767",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "MD00046521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rosario Skin Cliniic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.