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SUMMIT DERMATOLOGY PS
NPI 1639531445
Dermatology in Olympia, WA

Active since March 22, 2016CLIA 50D2228939 · Waiver
300 LILLY RD NE, UNIT A, OLYMPIA, WA 98506(360) 754-4352 Get Directions Write a Review

NPPES record last updated: March 22, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Summit Dermatology Ps NPPES

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

SUMMIT DERMATOLOGY PS (NPI 1639531445) is a healthcare organization registered as a dermatology in Olympia, Washington and active in the NPI registry since March 2016. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Jessica Kim, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1639531445
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSUMMIT DERMATOLOGY PS
Location Address300 LILLY RD NE, UNIT AOlympia, WA 98506-5428
Mailing Address300 Lilly Rd Ne, Unit AOlympia, WA 98506-5428
Phone(360) 754-4352
Organization SubpartNo
Authorized OfficialJessica KimOwner/president · (360) 754-4352
Enumeration DateMarch 22, 2016
✔ NPI 1639531445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in WA · MD00042827
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.
300 LILLY RD NE, Olympia, WA 98506
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Waiver 50D2228939

Summit Dermatology · Olympia, WA
Active · expires Apr 4, 2028
CLIA Number50D2228939
Laboratory TypePhysician Office
Certificate Effective DateJuly 2, 2021
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJessica Kim
Laboratory Phone(360) 918-8101
Laboratory LocationSummit Dermatology300 Lilly Rd NE Ste A, Olympia, WA 98506
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

EYE INSTITUTE OF OLYMPIA INC. P.S.
Ophthalmology
300 LILLY RD NE, SUITE C
OLYMPIA, WA 98506
Thurston County (360) 438-2207
MEGAN ELIZABETH HUTCHINSON PT, DPT
Physical Therapist (Orthopedic)
300 LILLY RD NE
OLYMPIA, WA 98506
Thurston County (360) 352-7352
CHANDNI KAUR VIRDI ARNP
Nurse Practitioner
300 LILLY RD NE, SUITE A
OLYMPIA, WA 98506
Thurston County (360) 252-9777
HEALTHY FUTURE PEDIATRICS
Pediatrics
300 LILLY RD NE, SUITE A
OLYMPIA, WA 98506
Thurston County (360) 528-4220
LEONARD STEWART SEIFTER MD
Ophthalmology
300 LILLY RD NE, SUITE C
OLYMPIA, WA 98506
Thurston County (360) 438-2207
INTEGRATED REHABILITATION GROUP, PC
Clinic/Center (Physical Therapy)
300 LILLY RD NE, SUITE B
OLYMPIA, WA 98506
Thurston County (360) 352-7352

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 Summit Dermatology Ps's NPI number?

The NPI number for Summit Dermatology Ps is 1639531445. It was assigned to this organization in the NPPES registry on March 22, 2016.

Where is Summit Dermatology Ps located?

Summit Dermatology Ps is located at 300 Lilly Rd NE Unit A, Olympia, WA 98506. The listed phone number is (360) 754-4352.

What is Summit Dermatology Ps's specialty?

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

Does Summit Dermatology Ps hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2228939) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Summit Dermatology Ps was last updated on March 22, 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.