Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

City South Dermatology PLLC

Organization Dermatology Physician · NPI 1255946315

City South Dermatology PLLC is a Dermatology Physician in Kent, Washington. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

24604 104th Ave SE
Kent, WA 98030-5385
Phone: (617) 412-1987
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1255946315
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Lin — Governor · (617) 412-1987
Other names City South Dermatology; City South Dermatology
NPI enumeratedSeptember 14, 2020
Last updated in NPPESSeptember 18, 2020
Certification dateSeptember 18, 2020
Mailing address3715 196th St Sw Unit 2058, Lynnwood, WA 98036-3202