Healthcare Provider Details

I. General information

NPI: 1851324115
Provider Name (Legal Business Name): JOHN R STREIDL, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22833 BOTHELL EVERETT HIGHWAY C/O DERMSERVICE, SUITE 201
BOTHELL WA
98021
US

IV. Provider business mailing address

17000 140TH AVE NE UNIT 206
WOODINVILLE WA
98072
US

V. Phone/Fax

Practice location:
  • Phone: 425-486-2340
  • Fax: 425-483-8135
Mailing address:
  • Phone: 425-485-7985
  • Fax: 425-483-8135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD00039710
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberMD00039710
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberMD00039710
License Number StateWA

VIII. Authorized Official

Name: DR. JOHN R STREIDL
Title or Position: OWNER
Credential: MD
Phone: 425-485-7985