Llewellyn Phillips II M.D., Inc., P.S.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD00013579 Issued in WA

Legal business name

LLEWELLYN PHILLIPS II M.D., INC., P.S.

Practice address

4509 Talbot Rd S
Suite 200
Renton, WA 98055-6294

Phone

(425) 228-4520

Fax

(425) 226-0283

NPI assigned

Sep 20, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Llewellyn Phillips II, M.D.

Title

President

Phone

(425) 228-4900

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1710238449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 TALBOT RD S",
            "address_2": "SUITE 200",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556294",
            "telephone_number": "425-228-4520",
            "fax_number": "425-226-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 TALBOT RD S",
            "address_2": "SUITE 200",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556294",
            "telephone_number": "425-228-4520",
            "fax_number": "425-226-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LLEWELLYN PHILLIPS II M.D., INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "LLEWELLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-228-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00013579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBS",
            "identifier": "P618",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "071661015",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "120734144076",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1681105",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clive Kefei Liu, M.D.
• Elaine Liu, M.D.
• Jinlan Liu
• Mandy Yee-Mei Liu, RPH
• Wenguang Liu
• Emmie Yun-Mei Lo, RPH
• Janice Sau Ying Lo, OT
• Marlin Lobaton
• Theresa Lock, PHD
• Henry Loh

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.