Dominique Liddy, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

925 Seneca St
Mail Stop: H8-Gme
Seattle, WA 98101

Phone

(206) 583-6079

NPI assigned

Mar 29, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dominique Szymkiewicz Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1992556724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 SW 16TH ST APT 27",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081437",
            "telephone_number": "305-318-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SENECA ST",
            "address_2": "MAIL STOP: H8-GME",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98101",
            "telephone_number": "206-583-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDY",
        "first_name": "DOMINIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMINIQUE",
            "last_name": "SZYMKIEWICZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lloyd Turla Licuanan, MD
• Lida Turner MD, PLLC
• Julia Liddane, PA-C
• Marti Liddell, M.D.
• Katelyn Amicia Liddle
• Benjamin Lidgard, M.D.
• Kathryn Amanda Lidgard, LSWAIC
• Aliza Silka Lieb
• Sarah Kay Lieb, B.D.
• Claire Gertrude Lieberman, RD,

• Student in an Organized Health Care Education/Training Program in Seattle, WA
• Providers in Seattle, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.