Lombillo, Vivian A

Lombillo, Vivian A is an individual health care provider with primary practice located at 703 Lilly Rd Ne Suite 105 Northwest Pediatric Dermatology, Pllc, Olympia WA 98506. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Pediatric Dermatology is her primary health care specialty. Lombillo, Vivian A can be contacted via phone (360) 539-6141.

Contact Information

Primary practice address
703 Lilly Rd Ne Suite 105 Northwest Pediatric Dermatology, Pllc Olympia WA 98506
Phone: (360) 539-6141
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Dermatology 207NP0225X MD00046225 Washington
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD00046225 Washington

Profile Details

NPI number 1013938620
LBN Legal business name Lombillo, Vivian A
Credentials MD PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Feb 21st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013938620 NPPES
Washington MEDICAID 03367104

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