Integrative Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

INTEGRATIVE DERMATOLOGY

Practice address

1607 Creekside Loop Ste 140
Yakima, WA 98902-4882

Phone

(509) 794-1434

Fax

(509) 774-3220

NPI assigned

Oct 1, 2024

Organization subpart

No

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

Authorized official

Name

Jennifer MartinNPI 1477704559

Title

PA-C

Phone

(509) 794-1434

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

Practitioners 2

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.

• Jennifer Martin, PA-C

  • Physician Assistant
  • Yakima, WA
  • NPI 1477704559
  Medicare reassignment Care Compare group Authorized official
• Jeffrey C Vantroba, PA-C

  • Medical Physician Assistant
  • Yakima, WA
  • NPI 1669493516
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1891513651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 CREEKSIDE LOOP STE 140",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989024882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 CREEKSIDE LOOP STE 140",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989024882",
            "telephone_number": "509-794-1434",
            "fax_number": "509-774-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PA-C",
        "authorized_official_telephone_number": "509-794-1434"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innominds LLC (West Valley Pharmacy)
• Innominds LLC
• Carol Grow Inouye, ARNP, MS
• Insight Diagnostic Imaging PA
• Institute for Family Development
• Interpretation Services
• Jack Daniel Ip, M.D.
• Lindsay Marie Irion, RD, CD
• David Isaac
• Kathleen McWhirter Isbell, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.