Healthcare Provider Details

I. General information

NPI: 1386084903
Provider Name (Legal Business Name): DERMAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 N 115TH ST SUITE 201
SEATTLE WA
98133-8414
US

IV. Provider business mailing address

2829 140TH AVE NE
BELLEVUE WA
98005-1826
US

V. Phone/Fax

Practice location:
  • Phone: 206-368-1244
  • Fax: 206-368-1270
Mailing address:
  • Phone: 713-868-8006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberMD60092323
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberMD60092323
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License NumberMD60092323
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberMD60092323
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberMD60092323
License Number StateWA

VIII. Authorized Official

Name: NILUFER BOZDEMIR NORSWORTHY
Title or Position: OWNER/PROVIDER
Credential: M.D.
Phone: 713-868-8006