Skin Cancer Clinic of Seattle Inc PS

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SKIN CANCER CLINIC OF SEATTLE INC PS

Practice address

1801 NW Market St
Suite 107
Seattle, WA 98107-3987

Phone

(909) 335-8638

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Darrell Fader, MD

Title

Owner

Phone

(909) 335-8638

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298851200000",
    "number": "1780740498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24922",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981240922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NW MARKET ST",
            "address_2": "SUITE 107",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073987",
            "telephone_number": "909-335-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CANCER CLINIC OF SEATTLE INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2011-02-28",
        "status": "A",
        "authorized_official_last_name": "FADER",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-335-8638",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Skidmore
• Sheri Skidmore
• Kevin Drew Skiena, LICSW
• Corrina Lea Skildum, MA, LMHC
• Christy A. Skimming, MSW, LICSW
• Skin Surgery Center PS
• Skin Surgery Center, P.S.
• Camille Midori Skinner
• Lindsay Paige Skinner, DPT
• Michelle A Skinner, PHD

• Dermatology Physician in Seattle, WA
• Providers in Seattle, 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 28, 2011; 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.