PINNACLE DERMATOLOGY (NPI# 1588897102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588897102 |
| Entity Type | Organization |
| Organization Name | PINNACLE DERMATOLOGY |
| Practice Address |
1515 116th Ave Ne Ste 307 Bellevue WA 98004-3811 |
| Mailing Address |
Po Box 3418 Kirkland WA 98083-3418 |
| Practice Telephone | 4259992628 |
| Practice Fax Number | 2535599020 |
| Mailing Telephone | 4259992628 |
| Mailing Fax Number | 2535599020 |
| Enumeration Date | 2009-08-30 |
| Last Update Date | 2015-03-23 |
| Authorized Official Name | DR. DEETTA M GRAY (SOLE MEMBER) |
| Authorized Official Telephone | 4259992628 |
| Authorized Official Credential | M.D. FAAD FRCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD025209MD000354 | WA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PINNACLE DERMATOLOGY, PLLC | 1515 116th Ave Ne Ste 307, Bellevue, WA 98004-3811 |
| Street Address |
1515 116TH AVE NE STE 307 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-3811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033132410 | Jf Rosenwald Dds Ps | Dentist | 1515 116th Ave Ne, Suite 305, Bellevue, WA 98004-3811 | 2006-07-25 |
| 1659775419 | Coho Medical Group, Pllc | Internal Medicine | 1515 116th Ave Ne, Suite 201, Bellevue, WA 98004-3811 | 2014-10-22 |
| 1295073997 | Bellevue Hyperbarics,pllc | Clinic/Center | 1515 116th Ave Ne, Suite 202, Bellevue, WA 98004-3811 | 2013-01-30 |
| 1104124247 | Bellevue Obgyn LLC | Obstetrics & Gynecology | 1515 116th Ave Ne, 205, Bellevue, WA 98004-3811 | 2011-03-13 |
| 1922319722 | Jessica Ann Jones | Massage Therapist | 1515 116th Ave Ne, Suite 109, Bellevue, WA 98004-3811 | 2010-06-25 |
| 1184944332 | Restorix Medical Group Pllc | Specialist | 1515 116th Ave Ne, Suite 300, Bellevue, WA 98004-3811 | 2010-06-09 |
| 1417183682 | Sound Acupuncture & Herbs, LLC | Acupuncturist | 1515 116th Ave Ne, Ste 109, Bellevue, WA 98004-3811 | 2009-06-02 |
| 1033355581 | Bellevue Neuromuscular Dentistry LLC | Dentist | 1515 116th Ave Ne, Suite 303, Bellevue, WA 98004-3811 | 2009-01-05 |
| 1548405418 | Michael Nelson Brown | Pain Medicine | 1515 116th Ave Ne, Suite #202, Bellevue, WA 98004-3811 | 2008-12-08 |
| 1962667865 | Jacob D Perkins | Chiropractor | 1515 116th Ave Ne, Suite 202, Bellevue, WA 98004-3811 | 2008-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760646269 | Carla J. Bauman, Md | Dermatology | 1260 116th Ave Ne Ste 100, Bellevue, WA 98004-3800 | 2008-07-14 |
| 1023144094 | Samir P. Master | Dermatology | 832 102nd Ave Ne, Bellevue, WA 98004-4117 | 2007-02-26 |
| 1639278260 | Thomas W Weir | Dermatology | 1515 116th Ave Ne Ste 202, Bellevue, WA 98004-3811 | 2006-09-21 |
| 1922107523 | Ray A Carlsen | Dermatology | 2330 130th Ave Ne Ste 201, Bellevue, WA 98005-1756 | 2006-09-21 |
| 1316049331 | John Leo Winfield | Dermatology | 1551 116th Ave Ne, Bellevue, WA 98004 | 2006-09-01 |
| 1578673372 | Kyle Justin Garton | Dermatology | 2330 130th Ave Ne, Suite 201, Bellevue, WA 98005-1756 | 2006-08-30 |
| 1790793487 | Clive Maopang Liu | Dermatology | 1810 116th Ave Ne Ste 100, Bellevue, WA 98004 | 2006-08-04 |
| 1952365140 | Elizabeth Chandler Hughes | Dermatology | 626 120th Ave Ne, Ste B104, Bellevue, WA 98005-3077 | 2006-04-14 |
| 1699736843 | Diane S Chiu | Dermatology | 1200 112th Ave Ne Ste C187, Bellevue, WA 98004-3749 | 2006-03-29 |
| 1952381733 | Carla J Bauman | Dermatology | 626 120th Ave Ne Ste B104, Bellevue, WA 98005-3077 | 2006-01-18 |
| Find all providers in BELLEVUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.