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LAKE WASHINGTON DERMATOLOGY
NPI 1114235942
Dermatology in Kirkland, WA

Active since September 14, 2010CLIA 50D0966896 · Certificate of Compliance
10117 NE 58TH ST STE 200, KIRKLAND, WA 98033(425) 821-6363(425) 821-4804 Get Directions Write a Review

NPPES record last updated: March 29, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lake Washington Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE WASHINGTON DERMATOLOGY (NPI 1114235942) is a healthcare organization registered as a dermatology in Kirkland, Washington and active in the NPI registry since September 2010. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028 and lists Susan H Kim, Physician, as its authorized official.

NPPES Registry Identity

NPI1114235942
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSUSAN KIM MD PS
Location Address10117 NE 58TH ST STE 200Kirkland, WA 98033-7450
Mailing Address10117 Ne 58th St Ste 200Kirkland, WA 98033-7450 · (425) 821-6363 · Fax (425) 821-4804
Phone(425) 821-6363
Fax(425) 821-4804
Organization SubpartNo
Authorized OfficialSusan H KimPhysician · (425) 821-6363
Enumeration DateSeptember 14, 2010
Last NPPES UpdateMarch 29, 2016
✔ NPI 1114235942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in WA · MD00037239
Definition
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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X · License MD00037239 (WA)
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X · License MD00037239 (WA)
10117 NE 58TH ST STE 200, Kirkland, WA 98033
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Other Names 1

Doing Business AsLake Washington Dermatology

Other Identifiers 1

Medicare PING8918028WA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 50D0966896

Lake Washington Dermatology · Kirkland, WA
Active · expires Apr 4, 2028
CLIA Number50D0966896
Laboratory TypePhysician Office
Certificate Effective DateJanuary 15, 2015
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJoan Leavens
Laboratory Phone(217) 503-0983
Laboratory LocationLake Washington Dermatology10117 NE 58th St Ste 200, Kirkland, WA 98033
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELISSA A PRASATIK PA-C
Physician Assistant
10117 NE 58TH ST STE 200
KIRKLAND, WA 98033
King County (425) 821-6363

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Kim MD Ps's NPI number?

The NPI number for Susan Kim MD Ps is 1114235942. It was assigned to this organization in the NPPES registry on September 14, 2010. The provider is doing business as Lake Washington Dermatology.

Where is Susan Kim MD Ps located?

Susan Kim MD Ps is located at 10117 NE 58th St Ste 200, Kirkland, WA 98033. The listed phone number is (425) 821-6363.

What is Susan Kim MD Ps's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Susan Kim MD Ps hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D0966896) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Susan Kim MD Ps accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Susan Kim MD Ps as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Susan Kim MD Ps was last updated on March 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.