=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225560550
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HUGH NYMEYER MD, PHD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2017
-----------------------------------------------------
Last Update Date | 06/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 515 MINOR AVE STE 210
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98104-2113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-389-9540
-----------------------------------------------------
Fax | 206-838-9549
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 25608
-----------------------------------------------------
City | SALT LAKE CITY
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84125-0608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-320-4476
-----------------------------------------------------
Fax | 206-568-7043
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207N00000X
-----------------------------------------------------
Taxonomy Name | Dermatology Physician
-----------------------------------------------------
License Number | MD61232320
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------