MOD SKIN AND BODY CLINIC (NPI# 1801227327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801227327 |
Entity Type | Organization |
Organization Name | MOD SKIN AND BODY CLINIC |
Practice Address |
14130 Juanita Dr Ne Ste 110 Kirkland WA 98034-0127 |
Practice Telephone | 4254068455 |
Mailing Telephone | 4254068455 |
Enumeration Date | 2013-12-09 |
Last Update Date | 2014-01-10 |
Authorized Official Name | POLLY TABARES (CEO) |
Authorized Official Telephone | 4254068455 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | Other Service Providers |
Street Address |
14130 JUANITA DR NE STE 110 |
City | KIRKLAND |
State | WA |
Zip Code | 98034-0127 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
Find all providers in zip 98034 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881095750 | Sarah Karmali | Specialist | 14335 Simonds Rd Ne, Unit A304, Kirkland, WA 98034-9201 | 2014-09-10 |
1316284771 | Daniel Leonard Jones | Specialist | 10517 Ne 38th Pl Bldg 11, Kirkland, WA 98033-7926 | 2013-01-04 |
1326324674 | Kwesi E Coleman | Specialist | 11415 Ne 128th St, Ste 130, Kirkland, WA 98034 | 2011-11-01 |
1023315736 | Lynn Renee Brooks | Specialist | 4305 Lake Washington Blvd Ne, 2311, Kirkland, WA 98033-7883 | 2011-02-15 |
1730485848 | Norma Jean Campbell | Specialist | 11008 Ne 68th St, Apt. 712, Kirkland, WA 98033-7169 | 2011-02-07 |
1285957563 | Amy Paolinelli | Specialist | 10060 116th Ave Ne, Kirkland, WA 98033-5150 | 2010-03-01 |
1417182379 | Erika Brooke | Specialist | 611 4th Ave Ste 100, Kirkland, WA 98033-6019 | 2009-05-21 |
1558508812 | Alie M Miller | Specialist | 903 5th Ave, Suite 102, Kirkland, WA 98033-6348 | 2009-01-08 |
1437305141 | Mti Physical Therapy Kirkland | Specialist | 11800 Ne 128th St Ste 510, Kirkland, WA 98034-7208 | 2008-08-13 |
1720245459 | Francis X. Riedo, Md | Specialist | 11911 Ne 132nd St Ste 100, Kirkland, WA 98034-2900 | 2008-05-20 |
Find all providers in KIRKLAND |
Please comment or provide details below to improve the information on MOD SKIN AND BODY CLINIC.
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.