OrganizationActive
City South Dermatology PLLC
NPI 1255946315 · Dermatology Physician · Kent, WA
City South Dermatology PLLC is a Dermatology Physician organization in Kent, WA (NPI 1255946315).
Provider details
- NPI number
- 1255946315
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Richard Lin, Governor(617) 412-1987
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
24604 104th Ave Se
Kent, WA 98030-5385
Phone: (617) 412-1987
Street-level locationGet directions
Mailing address
3715 196th St Sw Unit 2058
Lynnwood, WA 98036-3202
Other names (DBA / former)
- Other name
- City South Dermatology
- Other name
- City South Dermatology
Registry dates
- Enumerated
- 2020-09-14
- Last updated
- 2020-09-18
- Certified
- 2020-09-18
Frequently asked questions
- What is City South Dermatology PLLC's NPI number?
- City South Dermatology PLLC's National Provider Identifier (NPI) is 1255946315, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is City South Dermatology PLLC?
- City South Dermatology PLLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is City South Dermatology PLLC located?
- City South Dermatology PLLC's practice location on file with NPPES is 24604 104th Ave Se, Kent, WA 98030-5385.
- What is City South Dermatology PLLC's phone number?
- The practice phone number listed in the NPPES registry for City South Dermatology PLLC is (617) 412-1987.
- Who is the authorized official for City South Dermatology PLLC?
- The authorized official listed on City South Dermatology PLLC's NPPES record is Richard Lin, Governor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is City South Dermatology PLLC's NPI active?
- Yes — City South Dermatology PLLC's NPI (1255946315) is active in the NPPES registry as of the last update on 2020-09-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.