Anacortes Dermatology PC INC
Dermatology, Procedural Dermatology in Anacortes, WA. Organization (NPI-2).
NPI number1790057792
StatusActive
Last updated in NPPESFeb 27, 2024
Details
- NPI
- 1790057792
- Entity type
- Organization (NPI-2)
- Legal business name
- Anacortes Dermatology PC INC
- Organization subpart
- No
- Enumeration date
- Feb 6, 2012
- Last updated
- Feb 27, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207NS0135X | Dermatology, Procedural Dermatology | – | – | Yes |
| 207N00000X | Dermatology | – | – | |
| 207NP0225X | Dermatology, Pediatric Dermatology | – | – | |
| 261Q00000X | Clinic/Center | MD00045767 | WA |
Other names
- Anacortes Dermatology PC INC (Doing Business As)
- Anacortes Dermatology (Doing Business As)
Practice location
1801 Commercial AveAnacortes, WA 98221
Phone 360-399-6036
Mailing address
1801 Commercial AveAnacortes, WA 98221
Phone 360-399-6036 · Fax 360-588-1691
Authorized official
Wirt Anderson Hines
President
3603958768
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