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NORTH PACIFIC DERMATOLOGY PS
NPI 1881845907
Clinic/Center - Ambulatory Surgical in Renton, WA

Active since October 07, 2008CLIA 50D1085511 · Certificate of Compliance
1412 SW 43RD ST, STE 205, RENTON, WA 98057(425) 264-0660(425) 264-0601 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018 (2 updates tracked since 2018).

About North Pacific Dermatology Ps NPPES

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

NORTH PACIFIC DERMATOLOGY PS (NPI 1881845907) is a healthcare organization registered as an ambulatory surgical in Renton, Washington and active in the NPI registry since October 2008. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028, maintains a secondary practice location in Bellevue, and lists Nobuyoshi Kageyama, Secretary/treasurer, as its authorized official.

NPPES Registry Identity

NPI1881845907
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameNORTH PACIFIC DERMATOLOGY PS
Location Address1412 SW 43RD ST, STE 205Renton, WA 98057-4803
Mailing Address1200 112th Ave Ne, Ste C187Bellevue, WA 98004-3732 · (425) 457-7900 · Fax (425) 264-0601
Phone(425) 264-0660
Fax(425) 264-0601
Organization SubpartNo
Authorized OfficialNobuyoshi KageyamaSecretary/treasurer · (425) 264-0660
Enumeration DateOctober 7, 2008
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1881845907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
1412 SW 43RD ST, Renton, WA 98057
Open in Google Maps ↗

Secondary Practice Location 1

Location 11200 112th Ave NE Ste C187Bellevue, WA 98004-3749 · Phone (425) 457-7900 · Fax (425) 264-0601

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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 50D1085511

North Pacific Dermatology, Ps · Bellevue, WA
Active · expires Apr 4, 2028
CLIA Number50D1085511
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJune 19, 2008
Certificate Expiration DateApril 4, 2028
Laboratory DirectorNobuyoshi Kageyama
Laboratory Phone(425) 457-7900
Laboratory LocationNorth Pacific Dermatology, Ps1200 112th Ave NE Ste C-187, Bellevue, WA 98004
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm 13132
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.
124 services112 patients
Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm 13121
This 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.
64 services57 patients
Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less 14060
This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.
21 services21 patients
Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm 13152
This procedure involves repairing a wound on your eyelids, nose, ears, or lip that is between 2.6 and 7.5 cm long. It's considered complicated due to the location and size. The doctor will clean, treat, and stitch the wound to promote healing.
20 services20 patients
Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602
This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.
15 services12 patients
Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less 15260
A full thickness skin graft is a procedure where a layer of skin is taken from one area of the body and transplanted to another. If it's done on the nose, ears, eyelids, or lips, it helps restore these areas when damaged. The size of the graft is 20.0 sq cm or less.
12 services11 patients

Other Providers at the Same Location NPPES 20

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

MR. TIMOTHY STEWART MACP, MDIV, LMHCA
Counselor (Mental Health)
1412 SW 43RD ST, SUITE 111
RENTON, WA 98057
King County (425) 496-4411
GABREIL SANTANA
Technician
1412 SW 43RD ST
RENTON, WA 98057
King County (206) 971-8830
AWA TOURAY
Student in an Organized Health Care Education/Training Program
1412 SW 43RD ST
RENTON, WA 98057
King County (646) 474-1822
EVELYN SPIEKER MN, ARNP
Nurse Practitioner (Women's Health)
1412 SW 43RD ST, SUITE 200
RENTON, WA 98057
King County (425) 271-4910
MR. JAMISON R RIDGELEY MD
Ophthalmology
1412 SW 43RD ST, SUITE 206
RENTON, WA 98057
King County (253) 236-5720
PACIFIC RETINA CENTER PLLC
Ophthalmology (Retina Specialist)
1412 SW 43RD ST
RENTON, WA 98057
King County (910) 742-7427
PAVILLE V. CASTILLO
Counselor
1412 SW 43RD ST
RENTON, WA 98057
King County (425) 264-0750
ASSOCIATED VALLEY COUNSELING, LLC
Counselor (Mental Health)
1412 SW 43RD ST, SUITE 111
RENTON, WA 98057
King County (206) 229-5025

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 Ps's NPI number?

The NPI number for North Pacific Dermatology Ps is 1881845907. It was assigned to this organization in the NPPES registry on October 7, 2008.

Where is North Pacific Dermatology Ps located?

North Pacific Dermatology Ps 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 Ps's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does North Pacific Dermatology Ps hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D1085511) 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 North Pacific Dermatology Ps accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list North Pacific Dermatology 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 North Pacific Dermatology Ps was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.