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General NPI Number Information
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NPI Number | 1992865869
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Entity Type | Individual
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Provider Name | DEREK GEORGE DOMBROSKI MD
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 615 LILLY RD NE STE 100
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City | OLYMPIA
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State | WA
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Zip | 98506-5117
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Country | US
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Telephone | 360-491-4211
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Fax | 360-493-0407
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Provider Business Mailing Address
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Address Line | 3382 WAIALAE AVE
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City | HONOLULU
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State | HI
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Zip | 96816-2637
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Country | US
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Telephone | 808-548-7033
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | MD61552497
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License Number State | WA
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