Walter Leroy Williams, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD.MD.00041565 Issued in WA

Practice address

1433 5TH St
Clarkston, WA 99403-2714

Phone

(509) 758-5141

Fax

(509) 758-5299

NPI assigned

Mar 16, 2006

Last updated

Aug 4, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Kansas School of Med (KC/Wich/Sal), 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology of Clarkston PLLCGroup PAC ID 5597102335, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.65 of 100Reported as group

Quality

79.3

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob I. Blazzard, PA-C

  • Physician Assistant
  • Clarkston, WA
  • NPI 1326125485
  Medicare reassignment
• Lark Greenwald Guss, M.D.

  • MOHS-Micrographic Surgery Physician
  • Spokane, WA
  • NPI 1275973398
  Medicare reassignment
• James Michael Komorous, MD

  • Dermatology Physician
  • Clarkston, WA
  • NPI 1053313411
  Medicare reassignment
• Jennifer Lynn Nicholas, FNP

  • Nurse Practitioner
  • Clarkston, WA
  • NPI 1083978837
  Medicare reassignment
• Carolyn Jean Shoemaker, PA-C

  • Physician Assistant
  • Clarkston, WA
  • NPI 1477856649
  Medicare reassignment
• Lindsey Dawn Goddard, M.D.

  • Dermatology Physician
  • Wausau, WI
  • NPI 1639565872

  WA

  Medicare reassignment
• Jennifer Seegmiller, FNP-C

  • Nurse Practitioner
  • Payson, UT
  • NPI 1194132431

  WA

  Medicare reassignment

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrated Dermatology of Clarkston PLLC

  • Dermatology Physician
  • Clarkston, WA
  • NPI 1609656222
  Medicare reassignment Care Compare group NPD
• Walter Williams

  dba Dermatology & Skin Cancer Center

  • Specialist
  • Clarkston, WA
  • NPI 1528103579
  Authorized official Same address or phone

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1841269248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-948-0291",
            "fax_number": "561-859-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 5TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032714",
            "telephone_number": "509-758-5141",
            "fax_number": "509-758-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "WALTER",
        "middle_name": "LEROY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD.MD.00041565",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD.MD.00041565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD PROV.",
            "identifier": "000010139009",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON MEDICAID #",
            "identifier": "1117878",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806377300",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON LICENSE",
            "identifier": "MD00041565",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "P00007739",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "72157",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS #",
            "identifier": "030734610",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Whittlesey, DDS
• Lear Anthony Wickens, RPH
• Dana Majors Wiggins
• Amanda Wilkins
• Brandi Williams
• Benjamin Wise, PHARM.D
• Deborah Withey
• Joel Woodruff, MD
• Chelsey Marie Woods, RDN
• Eric Wright, MA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.