PACIFIC DERMATOLOGY AND COSMETIC CENTER
NPI 1417163635
Clinic/Center - Ambulatory Surgical in Seattle, WA
NPI Status: Active since May 15, 2007
Contact Information
11011 MERIDIAN AVE N
SUITE 102
SEATTLE, WA
ZIP 98133
Phone: (206) 859-5777
Fax: (206) 859-5776
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
- CLIA Number: 50D2106019
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-04-2028
About PACIFIC DERMATOLOGY AND COSMETIC CENTER
This page provides the complete NPI Profile along with additional information for Pacific Dermatology And Cosmetic Center, a provider established in Seattle, Washington operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1417163635 assigned on May 2007. The practitioner's primary taxonomy code is 261QA1903X with license number MD00042289 (WA). The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Pacific Dermatology And Cosmetic Center. The authorized official of this NPI record is Malissa Kobbevik (Credentialing Manager)
- NPI
- 1417163635
- Provider Legal Name
- SILVER FALLS DERMATOLOGY, LLC
- Other Organization Name
- PACIFIC DERMATOLOGY AND COSMETIC CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 11011 MERIDIAN AVE N SUITE 102 SEATTLE, WA 98133
- Location Phone
- (206) 859-5777
- Location Fax
- (206) 859-5776
- Mailing Address
- PO BOX 741825 LOS ANGELES, CA 90074
- Mailing Phone
- (206) 859-5777
- Mailing Fax
- (206) 859-5776
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-15-2007
- Last Update Date
- 10-17-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
- License No.
- MD00042289
- License State
- WA
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207ND0101X | Allopathic & Osteopathic Physicians | Dermatology | |
| 2 | 207NS0135X | Allopathic & Osteopathic Physicians | Dermatology |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm
Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm
This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.
This service was performed 13 times for 12 patientsThis is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.
This service was performed 16 times for 16 patientsCLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 50D2106019
- Facility Type
- Physician Office
- Certificate Effective Date
- July 01, 2025
- Certificate Expiration Date
- April 04, 2028
- Laboratory Director
- DIETER SCHMIDT
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Pacific Dermatology And Cosmetic Center in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1417163635, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SEATTLE, WA 98133
SEATTLE, WA 98133
SEATTLE, WA 98133
SEATTLE, WA 98133
SEATTLE, WA 98133
SEATTLE, WA 98133
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417163635, enumerated as an "organization" on May 15, 2007.
The provider is located at 11011 MERIDIAN AVE N SUITE 102 SEATTLE, WA 98133 and the phone number is (206) 859-5777.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska and. Please consult your insurance carrier or call the provider to verify.
