DR. VIVIAN A LOMBILLO MD PHD NPI 1013938620

NPI Information

NPI: 1013938620
Provider Name: DR. VIVIAN A LOMBILLO, MD PHD
Classification: Dermatology - 207NP0225X
Entity Type: Individual

Specialization: Pediatric Dermatology

PECOS Registration: Yes

Address:
703 LILLY RD NE SUITE 105
NORTHWEST PEDIATRIC DERMATOLOGY, PLLC
OLYMPIA, WA
ZIP 98506
Phone: (360) 539-6141
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DR. Vivian A Lombillo, MD PHD is a pediatric dermatology dermatology in Olympia, WA. The provider is a pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. DR. Vivian A Lombillo, MD PHD NPI is 1013938620. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

703 LILLY RD NE SUITE 105
NORTHWEST PEDIATRIC DERMATOLOGY, PLLC
OLYMPIA, WA
ZIP 98506
Phone: (360) 539-6141

The NPI 1013938620 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 2/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207NP0225X	Dermatology	Pediatric Dermatology	MD00046225	WASHINGTON	Yes
2	207N00000X	Dermatology		MD00046225	WASHINGTON	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	03367104	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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