SILVER FALLS DERMATOLOGY LLC NPI 1417163635

NPI Information

  • NPI: 1417163635
  • Provider Name: SILVER FALLS DERMATOLOGY, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: PACIFIC DERMATOLOGY AND COSMETIC CENTER
  • CLIA Number: 50D2106019
  • Address: 11011 MERIDIAN AVE N
    SUITE 102
    SEATTLE, WA
    ZIP 98133
  • Phone: (206) 859-5777

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NPI Details

SILVER FALLS DERMATOLOGY, LLC is an ambulatory surgical clinic center in Seattle, WA. SILVER FALLS DERMATOLOGY, LLC NPI is 1417163635. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Pacific Dermatology And Cosmetic Center.

The provider's business location address is:

11011 MERIDIAN AVE N
SUITE 102
SEATTLE, WA
ZIP 98133-967
Phone: (206) 859-5777
Fax: (206) 859-5776

The provider's authorized official is Malissa Kobbevik .
The authorized official title is Credentialing Manager and has the following contact phone number (360) 375-2038.

The CLIA number assigned to this NPI record is 50D2106019 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm (HCPCS:13121)
  • Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm (HCPCS:13132)

The enumeration date for this NPI number is 5/15/2007 and was last updated on 10/17/2024.

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
1207ND0101XDermatologyMOHS-Micrographic SurgeryNo
2207NS0135XDermatologyProcedural DermatologyNo
3261QA1903XClinic/CenterAmbulatory SurgicalMD00042289WASHINGTONYes

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: 11/21/2025

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