ISLAND COUNTY DERMATOLOGY PLLC NPI 1649281320

NPI Information

  • NPI: 1649281320
  • Provider Name: ISLAND COUNTY DERMATOLOGY PLLC
  • Classification: Dermatology - 207N00000X
  • Entity Type: Organization
  • Doing Business As: WHIDBEY DERMATOLOGY
  • Address: 205 S MAIN ST
    BLG A
    COUPEVILLE, WA
    ZIP 98239
  • Phone: (360) 678-6561

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NPI Details

ISLAND COUNTY DERMATOLOGY PLLC is a dermatology in Coupeville, WA. The provider is 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. ISLAND COUNTY DERMATOLOGY PLLC NPI is 1649281320. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Whidbey Dermatology.

The provider's business location address is:

205 S MAIN ST
BLG A
COUPEVILLE, WA
ZIP 98239-500
Phone: (360) 678-6561
Fax: (360) 678-7133

The provider's authorized official is Donald Russell Johnson .
The authorized official title is Owner, Medical Director and has the following contact phone number (360) 678-6561.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 9/28/2010.

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
1207N00000XDermatologyMD00038058WASHINGTONYes

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
1GAB20723MEDICARE ID-TYPE UNSPECIFIEDWASHINGTON
21598790990OTHERWASHINGTONNPI
3G8856648MEDICARE PINWASHINGTON
4GAB20722MEDICARE PINWASHINGTON
5G88409MEDICARE UPINWASHINGTON
61108877MEDICAIDWASHINGTON

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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