NPIMap

Organization Active NPI

West Sound Dermatology PLLC

  • Dermatology Physician
  • Poulsbo, WA
National Provider Identifier
1821468596
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
31070 Issued in WA
Legal business name
WEST SOUND DERMATOLOGY PLLC
Practice address
19917 7TH Ave NE
Ste 203
Poulsbo, WA 98370-6555
Phone
(360) 824-5474
NPI assigned
Oct 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Authorized official

Name
Dr. Simone Ince, M.D.NPI 1841327822
Title
Owner
Phone
(360) 824-5474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 31070 WA Primary

Addresses

Primary practice location

19917 7TH Ave NE
Ste 203
Poulsbo, WA 98370-6555

Mailing address

19917 7TH Ave NE
Ste 203
Poulsbo, WA 98370-6555
Phone (360) 824-5474

National Provider Directory

National Provider Directory

Locations

19917 7th Ave NE
Ste 203
Poulsbo, WA 98370
Phone (360) 824-5474

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1821468596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19917 7TH AVE NE",
            "address_2": "STE 203",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706555",
            "telephone_number": "360-824-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19917 7TH AVE NE",
            "address_2": "STE 203",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706555",
            "telephone_number": "360-824-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SOUND DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "INCE",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-824-5474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WA",
            "license": "31070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.