Eastside Dermatology Inc PS

Primary specialty

Pediatric Dermatology PhysicianTaxonomy code 207NP0225X

Legal business name

EASTSIDE DERMATOLOGY INC PS

Practice address

14030 NE 24TH St
Suite 202
Bellevue, WA 98007-3724

Phone

(425) 454-1104

Fax

(425) 454-1290

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Melanie A Jennings

Title

Office Manager

Phone

(425) 454-1104

Specialties & licenses 3

Addresses

Other identifiers 2

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

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1649379231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14030 NE 24TH ST",
            "address_2": "SUITE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073724",
            "telephone_number": "425-454-1104",
            "fax_number": "425-454-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14030 NE 24TH ST",
            "address_2": "SUITE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073724",
            "telephone_number": "425-454-1104",
            "fax_number": "425-454-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE DERMATOLOGY INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-454-1104",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7080237",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDIACRE",
            "identifier": "CN9262",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastside Addiction Professionals
• Eastside Anxiety PLLC
• Eastside Behavioral Medicine
• Eastside Birth Center, PS
• Eastside Chiropractic Group a Professional Service Corporation
• Eastside Endocrinology and Diabetes, PS
• Eastside Family Medicine Clinic
• Eastside Fertility Lab Inc
• Eastside Integrative Health
• Eastside Internal Medicine & Cardiology David B Ferrin MD

• Pediatric Dermatology Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Pediatric Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.