Provider Demographics
NPI:1386084903
Name:DERMAN PLLC
Entity type:Organization
Organization Name:DERMAN PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:NILUFER
Authorized Official - Middle Name:BOZDEMIR
Authorized Official - Last Name:NORSWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-868-8006
Mailing Address - Street 1:2829 140TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1826
Mailing Address - Country:US
Mailing Address - Phone:713-868-8006
Mailing Address - Fax:
Practice Address - Street 1:1560 N 115TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8414
Practice Address - Country:US
Practice Address - Phone:206-368-1244
Practice Address - Fax:206-368-1270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60092323261Q00000X, 261QA1903X, 261QI0500X, 261QM1300X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1700016391OtherNPI
WAMD 60092323OtherSTATE LICENSE
WAMD 60092323OtherSTATE LICENSE