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NPI Code Detail

MEDICARE: REICHEL DERMATOLOGY ASSOCIATES, PLLC

MEDICARE: REICHEL DERMATOLOGY ASSOCIATES, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician
2207ND0101XMOHS-Micrographic Surgery Physician
3207ND0900XDermatopathology Physician
4207NI0002XClinical & Laboratory Dermatological Immunology Physician
5207NS0135XProcedural Dermatology Physician
6174400000XSpecialist

General Provider Information

NPI Number : 1871548214
Entity Type Code : Organization
Provider Name (Legal Business Name) : REICHEL DERMATOLOGY ASSOCIATES, PLLC
Provider Business Mailing Address
First Line : 11011 MERIDIAN AVE N
Second Line : SUITE 102
City : SEATTLE
State : WA
Zip : 98133-8967
Country : US
Telephone Number : 206-859-5777
Fax Number : 206-859-5776
Provider Business Practice Location Address
First Line : 11011 MERIDIAN AVE N
Second Line : SUITE 102
City : SEATTLE
State : WA
Zip : 98133-8967
Country : US
Telephone Number : 206-859-5777
Fax Number : 206-859-5776
Authorized Official
Title or Position : OWNER
Name : DR. JENNIFER LYNN REICHEL
Credential : MD
Telephone Number : 206-859-5777
Provider Enumeration Date : 05/24/2006
Last Update Date : 01/20/2021

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