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NORTH PACIFIC DERMATOLOGY SERVICES, LLC
NPI 1790973436
Dermatology in Renton, WA

Active since October 09, 2007CLIA 50D1052747 · Microscopy
1412 SW 43RD ST STE 205, RENTON, WA 98057(425) 264-0660(425) 264-0601 Get Directions Write a Review

NPPES record last updated: January 11, 2010. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About North Pacific Dermatology Services, Llc NPPES

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

NORTH PACIFIC DERMATOLOGY SERVICES, LLC (NPI 1790973436), doing business as North Pacific Dermatology, P.s., is a healthcare organization registered as a dermatology in Renton, Washington and active in the NPI registry since October 2007. The organization holds a CLIA Microscopy certificate valid through April 4, 2028 and lists Nicole P Kageyama, President, as its authorized official.

NPPES Registry Identity

NPI1790973436
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameNORTH PACIFIC DERMATOLOGY SERVICES, LLC
Location Address1412 SW 43RD ST STE 205Renton, WA 98057-4803
Mailing Address1412 Sw 43rd St Ste 205Renton, WA 98057-4803 · (425) 264-0660 · Fax (425) 264-0601
Phone(425) 264-0660
Fax(425) 264-0601
Organization SubpartNo
Authorized OfficialNicole P KageyamaPresident · (425) 264-0660
Enumeration DateOctober 9, 2007
Last NPPES UpdateJanuary 11, 2010
✔ NPI 1790973436 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 · MD00046078
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 · DermatopathologyTaxonomy 207ND0900X · License MTS-4912 (WA)
Also ListedClinic/Center · Ambulatory SurgicalTaxonomy 261QA1903X
1412 SW 43RD ST STE 205, Renton, WA 98057
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Other Names 1

Former Legal Business NameNorth Pacific Dermatology, P.s.

Other Identifiers 3

OtherDE5794WA · Railroad Medicare
Medicare UPINH64679WA
Medicare PING8858889WA

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

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) 50D1052747

North Pacific Dermatology, Ps · Renton, WA
Active · expires Apr 4, 2028
CLIA Number50D1052747
Laboratory TypePhysician Office
Certificate Effective DateJuly 25, 2024
Certificate Expiration DateApril 4, 2028
Laboratory DirectorNicole P. Kageyama
Laboratory Phone(425) 264-0660
Laboratory LocationNorth Pacific Dermatology, Ps3721 Talbot Rd S, Renton, WA 98055
CLIA data matches this NPI record on: 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

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

MRS. NICOLE PREVO KAGEYAMA M.D.
Dermatology
1412 SW 43RD ST STE 205
RENTON, WA 98057
King County (425) 264-0660

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 North Pacific Dermatology Services, LLC's NPI number?

The NPI number for North Pacific Dermatology Services, LLC is 1790973436. It was assigned to this organization in the NPPES registry on October 9, 2007. The provider was formerly known as North Pacific Dermatology, P.S..

Where is North Pacific Dermatology Services, LLC located?

North Pacific Dermatology Services, LLC is located at 1412 SW 43rd St Ste 205, Renton, WA 98057. The listed phone number is (425) 264-0660.

What is North Pacific Dermatology Services, LLC's specialty?

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

Does North Pacific Dermatology Services, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 50D1052747) 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 North Pacific Dermatology Services, LLC was last updated on January 11, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.