Individual provider Active NPI

John R Streidl, MD

  • Dermatology Physician
  • Seattle, WA
National Provider Identifier
1912931635
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD00039710 Issued in WA
Practice address
9709 3Rd Ave NE
Seattle, WA 98115-2062
Phone
(206) 860-4748
Fax
(206) 860-4756
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD00039710 WA Primary

Addresses

Primary practice location

9709 3Rd Ave NE
Seattle, WA 98115-2062

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other identifiers 1

IdentifierTypeStateIssuer
8290751MedicaidWA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040309000714 WA Practitioner - Dermatology 0749178937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Saint Louis University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

904 7TH Ave
Seattle, WA 98104-1132
Phone (206) 309-1760

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision30
Removal of skin lesions696
Removal or shaving of skin growth1-10
Skin biopsy273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00039710WAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Dermatology CurrentSince Dec 1, 2006 Accepting new patients
The Polyclinic PLLC CurrentSince Dec 1, 2006 Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

11011 Meridian Ave N
Ste 200
Seattle, WA 98133
Phone (206) 525-5777

Interoperability endpoints

  • Direct secure messaging: jstreidl23427@direct.tecmc.com
  • Direct secure messaging: jstreidl1068388@wm.providencedirect.org

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1912931635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9709 3RD AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152062",
            "telephone_number": "206-860-4748",
            "fax_number": "206-860-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREIDL",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00039710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8290751",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.