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EASTSIDE DERMATOLOGY INC PS
NPI 1649379231
Dermatology - Pediatric Dermatology in Bellevue, WA

Active since September 21, 2006CLIA 50D0697340 · Microscopy
14030 NE 24TH ST, SUITE 202, BELLEVUE, WA 98007(425) 454-1104(425) 454-1290 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Eastside Dermatology Inc Ps NPPES

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

EASTSIDE DERMATOLOGY INC PS (NPI 1649379231) is a healthcare organization registered as a pediatric dermatology in Bellevue, Washington and active in the NPI registry since September 2006. The organization holds a CLIA Microscopy certificate valid through April 4, 2028 and lists Melanie A Jennings, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1649379231
Entity TypeOrganization
Primary Taxonomy207NP0225X
Legal Business NameEASTSIDE DERMATOLOGY INC PS
Location Address14030 NE 24TH ST, SUITE 202Bellevue, WA 98007-3724
Mailing Address14030 Ne 24th St, Suite 202Bellevue, WA 98007-3724 · (425) 454-1104 · Fax (425) 454-1290
Phone(425) 454-1104
Fax(425) 454-1290
Organization SubpartNo
Authorized OfficialMelanie A JenningsOffice Manager · (425) 454-1104
Enumeration DateSeptember 21, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1649379231 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · Pediatric DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NP0225X
Definition
A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents.
Also ListedDermatologyTaxonomy 207N00000X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
14030 NE 24TH ST, Bellevue, WA 98007
Open in Google Maps ↗

Other Identifiers 2

Medicaid7080237WA
OtherCN9262WA · Railroad Mediacre

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 MULTIPLE SINGLE 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 for Provider-Performed Microscopy Procedures (PPMP) 50D0697340

Eastside Dermatology Inc Ps · Bellevue, WA
Active · expires Apr 4, 2028
CLIA Number50D0697340
Laboratory TypePhysician Office
Certificate Effective DateAugust 11, 2006
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAnna C. Tappel
Laboratory Phone(425) 454-1104
Laboratory LocationEastside Dermatology Inc Ps14030 NE 24th Street Suite 202, Bellevue, WA 98007
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 8

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

JULIE S FRANCIS MD
Dermatology (Pediatric Dermatology)
14030 NE 24TH ST, SUITE 202
BELLEVUE, WA 98007
King County (425) 454-1104
JIMMY ZHU D.D.S.
Dentist (General Practice)
14030 NE 24TH ST, SUITE #103
BELLEVUE, WA 98007
King County (425) 644-8485
SHARON B KELLY MD
Dermatology (Pediatric Dermatology)
14030 NE 24TH ST, SUITE 202
BELLEVUE, WA 98007
King County (425) 454-1104
LAURI M TADLOCK MD
Dermatology
14030 NE 24TH ST, SUITE 202
BELLEVUE, WA 98007
King County (425) 454-1104
G. B. STAHL, DDS, PLLC
Dentist
14030 NE 24TH ST, SUITE 100
BELLEVUE, WA 98007
King County (425) 641-3668
DR. RANDALL M. MAEBO D.D.S.
Dentist
14030 NE 24TH ST, SUITE 103
BELLEVUE, WA 98007
King County (425) 644-8485
KATHRYN W ERICKSON MD
Dermatology (Pediatric Dermatology)
14030 NE 24TH ST, SUITE 202
BELLEVUE, WA 98007
King County (425) 454-1104
DR. ERNEST MOHANDAS MADHAVAN MD
Psychiatry & Neurology (Psychiatry)
14030 NE 24TH ST, SUITE 104
BELLEVUE, WA 98007
King County (425) 637-3976

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 Eastside Dermatology Inc Ps's NPI number?

The NPI number for Eastside Dermatology Inc Ps is 1649379231. It was assigned to this organization in the NPPES registry on September 21, 2006.

Where is Eastside Dermatology Inc Ps located?

Eastside Dermatology Inc Ps is located at 14030 NE 24th St Suite 202, Bellevue, WA 98007. The listed phone number is (425) 454-1104.

What is Eastside Dermatology Inc Ps's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Pediatric Dermatology, with taxonomy code 207NP0225X.

Does Eastside Dermatology Inc Ps hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 50D0697340) 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 Eastside Dermatology Inc Ps accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Eastside Dermatology Inc 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 Eastside Dermatology Inc Ps was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.