Madrona Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35157 Issued in WA

Legal business name

MADRONA DERMATOLOGY PLLC

Practice address

13118 120TH Ave NE
Kirkland, WA 98034-3014

Phone

(650) 380-0776

NPI assigned

Feb 2, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Sarah Elizabeth Dick, M.D.NPI 1225089493

Title

Owner

Phone

(650) 380-0776

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 2

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

• Sarah Elizabeth Dick, MD

  • Dermatology Physician
  • Kirkland, WA
  • NPI 1225089493
  Medicare reassignment Care Compare group NPD Authorized official
• Nhung Thi My Ho, P.A.

  • Physician Assistant
  • Kirkland, WA
  • NPI 1285166397
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1679963367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13118 120TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343014",
            "telephone_number": "650-380-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13118 120TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343014",
            "telephone_number": "650-380-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRONA DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "DICK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-380-0776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WA",
            "license": "35157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Jane Maclennan, MD
• Rachel Lynette Macor, LMHCA
• Chad Macpherson
• Lejla Madfai, LMHC
• Jamila Madhani, M.D.
• Kyle Madsen
• Suzette Florence Madson, PT
• Robert Allen Maduzia, LAC.
• Angela Maeda, MAC, LMHC
• Matthew Emerson Justo Magbanua

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.