City South Dermatology Pllc

NPI #1255946315 in Kent, Washington

Provider Information

NPI Number: 1255946315
Entity Type: Organization
Organization Name: City South Dermatology Pllc
Primary Specialty: Dermatology
Enumeration Date: Sep 14, 2020
Last Updated: Sep 18, 2020

Practice Location

Address: 24604 104TH AVE SE
City: Kent
State: Washington
ZIP Code: 98030-5385
Phone: (617) 412-1987

Authorized Official

Name: RICHARD LEE-TSONG LIN, MD
Title: GOVERNOR
Phone: (617) 412-1987

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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