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Dr. Victor R. Michalak, MD

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(Dr. Victor Roman Michalak, M.D.)

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Specializes in: Dermatology (Skin Disorders)

Weill Cornell Medical College (1983)

Professional interests include: phototherapy (light therapy), lip biopsy, corns, and more.

295 Northeast Gilman Boulevard
Issaquah, WA 98027

(425) 391-2500

Dr. Victor R. Michalak, MD is a dermatologist in Issaquah, WA specializing in dermatology (skin disorders). He graduated from Weill Cornell Medical College in 1983 and has 43 years of experience. Dr. Victor R. Michalak, MD is affiliated with Swedish Medical Center, Providence and Evergreen Health.

Office Locations

Providence

295 Northeast Gilman Boulevard
Issaquah, WA 98027

(425) 391-2500

open_in_new

Some issues Dr. Victor R. Michalak, MD can help you with:

Chemical Peels

Chemical peels remove the outer layer of the skin using chemical solutions, like glycolic acid and phenol. Although most commonly performed on the face, this non-surgical procedure may be done on the neck and hands as well. Chemical peels can treat the following:

Age spots
Fine lines and wrinkles
Freckles
Rough skin
Sun-damaged skin
Acne

Before the procedure, a skin evaluation is done to determine which type of peel will produce the best results. Dark skin tends to respond well to light peels, while severely sun-damaged skin will likely benefit from a moderate or deep peel. Pre-treatment creams and sunscreen need to be applied every day for several weeks prior to the procedure. Doing this may help shorten the healing process.

During the peel, the area to be treated is cleaned thoroughly, and the chemical solution is applied on the skin for several minutes, which produces a stinging sensation. A neutralizing agent is then used, and the stinging sensation gradually goes away. For more intense peels, a cool compress may be placed on the area to relieve any stinging or burning, or the solution may be applied in intervals to limit exposure to the strong chemicals.

Following a light peel, there will be redness and swelling, which typically fade in a few days. Swelling after a moderate or deep peel may last for a week, and mild redness may continue for a few weeks. To help improve the final results of a peel, treated areas must be kept cool, moisturized, and protected from sunlight.

Dermabrasion

Dermabrasion, also known as dermaplaning, uses a high-speed rotating device to scrape away outer layers of the skin and create a smoother surface. This surgical procedure is most commonly used on the face, but it may be performed on other parts of the body as well. It treats the following skin issues:

Raised scars due to accidents, previous surgery, or acne.
Deep wrinkles.
Skin growths, like precancerous lesions.

During dermabrasion, a nurse or other healthcare professional holds the skin taut so that the doctor can apply gentle but constant pressure on the skin using the device. Depending on how much skin needs treatment, it may take a few minutes to over an hour to complete the surgery.

A waxy or moist dressing is placed on the skin at the end of the procedure. The treated area will be red and swollen for about two to three weeks. Itchiness and tingling will likely be present for some time. Although less common, enlarged pores, cold sores, rashes, and permanent skin discoloration may also occur. Normal activities may be resumed about two weeks following dermabrasion. However, swimming in chlorinated water and sports that involve the use of balls should be avoided for four to six weeks.

Hyperhidrosis (Excessive Sweating)

Hyperhidrosis is a medical condition where the sweat glands become overactive, leading to excessive sweating. It can occur in just one area, such as the armpits, feet, or hands; or it can be general sweating over the entire body. Hyperhidrosis can happen to people of all ages and genders. It is estimated that the condition affects as many as 3% of all people, but many are never diagnosed because they are too embarrassed to talk about their symptoms with their doctor.

When excessive sweating is the main complaint and is not related to any other condition, it is called primary hyperhidrosis. There is no known cause, but it does tend to run in families. Secondary hyperhidrosis is sweating that is caused by another medical condition, such as anxiety, cancer, hyperthyroidism, or menopause. Sometimes treating the underlying condition can improve this type of sweating.

There are tests doctors can use to diagnose hyperhidrosis. One involves simply soaking up the perspiration with paper and then weighing the paper to measure how much extra sweat is being produced. Another test, called the starch-iodine test, involves covering the body with powder. This powder turns blue in any areas where sweat is produced.

Treatment depends on the severity of the hyperhidrosis and the areas affected. Some options are:

Prescription antiperspirants, which contain aluminum chloride and work by plugging the sweat ducts. This signals the sweat glands to decrease sweat production. They work for moderate cases of hyperhidrosis and are relatively affordable.
Lontophoresis, a procedure that uses small amounts of electricity and a tray of tap water to decrease production of sweat glands in the hands or feet.
Botox, which can be injected into the nerves that control sweat glands in the underarms.
Sympathectomy, a surgery for severe cases that can be performed to cut the nerves that stimulate sweat production. Sympathectomy is most effective for hyperhidrosis of the hands. It may cause new symptoms of sweating elsewhere on the body.
Surgery to remove sweat glands, most often in the underarms.

Hyperhidrosis is a serious medical condition that causes both physical and emotional distress. Treatments are available, and support groups exist to help patients cope.

Noteworthy Medicare Patient Procedures Performed by Dr. Victor R. Michalak, MD in 2023

Click on any procedure below to see further details on volume and pricing among Medicare patients.

Top 5%

By Volume:

adjacent tissue transfer

In 2023, Dr. Victor R. Michalak, MD performed more adjacent tissue transfer procedures for Medicare patients than 95% of providers in related specialties within Washington.

Top 10%

By Affordability:

removal of benign skin lesion

skin lesion destruction

In 2023, Dr. Victor R. Michalak, MD had a list price for removal of benign (non-cancerous) skin lesion, and skin lesion destruction (e.g. laser surgery) that was lower than the list prices billed to Medicare by 90% of providers in related specialties within Washington. Actual amounts paid by patients can vary widely depending on a number of factors, including insurance coverage. A lower list price, however, might mean lower fees when paying without insurance.

Medicare Procedure and Patient Information

2012 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2012 were reconstructive surgery, plastic surgery procedures, wound repair (e.g. stitches) and tissue transfer.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	13
doctor visit	46
plastic surgery procedures	16
reconstructive surgery	16
removal of lesion (e.g. growth)	13
skin procedures	13
skin surgery	13
tissue transfer	16
wound repair (e.g. stitches)	16

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2013 were removal of lesion (e.g. growth), skin surgery, skin procedures and cancer surgery.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	36
doctor visit	46
plastic surgery procedures	21
reconstructive surgery	21
removal of lesion (e.g. growth)	36
skin procedures	36
skin surgery	36
tissue transfer	21
wound repair (e.g. stitches)	21

2013 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	51
Female	64

**Age**
From 65 to 74	44
From 75 to 84	45
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2013

Hypertension	57
High Cholesterol	50
Stroke	0
Ischemic Heart Disease	30
Depression	14
Chronic Kidney Disease	0
Asthma	0
Osteoperosis	0
Atrial Fibrilation	16
Heart Failure	10
Chronic Obstructive Pulmonary Disease	0
Diabetes	20
Dementia	11
Cancer	11

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2014 were reconstructive surgery, plastic surgery procedures, wound repair (e.g. stitches) and tissue transfer.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	11
doctor visit	31
plastic surgery procedures	26
reconstructive surgery	26
removal of lesion (e.g. growth)	11
skin procedures	11
skin surgery	11
tissue transfer	26
wound repair (e.g. stitches)	26

2014 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	50
Female	43

**Age**
From 65 to 74	37
From 75 to 84	41
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2014

Hypertension	49
High Cholesterol	45
Stroke	0
Ischemic Heart Disease	19
Depression	19
Chronic Kidney Disease	17
Asthma	0
Osteoperosis	0
Atrial Fibrilation	17
Heart Failure	0
Chronic Obstructive Pulmonary Disease	0
Diabetes	17
Dementia	0
Cancer	0

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2015 were reconstructive surgery, plastic surgery procedures, wound repair (e.g. stitches) and tissue transfer.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	12
doctor visit	67
plastic surgery procedures	29
reconstructive surgery	29
removal of lesion (e.g. growth)	12
skin procedures	12
skin surgery	12
tissue transfer	29
wound repair (e.g. stitches)	29

2015 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	118
Female	124

**Age**
From 65 to 74	94
From 75 to 84	102
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2015

Hypertension	55
High Cholesterol	45
Stroke	0
Ischemic Heart Disease	21
Depression	13
Chronic Kidney Disease	20
Asthma	0
Osteoperosis	0
Atrial Fibrilation	14
Heart Failure	0
Chronic Obstructive Pulmonary Disease	0
Diabetes	21
Dementia	0
Cancer	12

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2016 were removal of lesion (e.g. growth), skin surgery, skin procedures and cancer surgery.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	54
doctor visit	88
plastic surgery procedures	33
reconstructive surgery	33
removal of lesion (e.g. growth)	54
skin procedures	54
skin surgery	54
tissue transfer	33
wound repair (e.g. stitches)	33

2016 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	69
Female	79

**Age**
From 65 to 74	65
From 75 to 84	52
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2016

Hypertension	51
High Cholesterol	41
Stroke	0
Ischemic Heart Disease	28
Depression	17
Chronic Kidney Disease	22
Asthma	12
Osteoperosis	0
Atrial Fibrilation	17
Heart Failure	14
Chronic Obstructive Pulmonary Disease	0
Diabetes	22
Dementia	0
Cancer	11

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2017 were removal of lesion (e.g. growth), skin surgery, skin procedures and cancer surgery.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	66
doctor visit	95
plastic surgery procedures	44
reconstructive surgery	44
removal of lesion (e.g. growth)	66
skin procedures	66
skin surgery	66
tissue transfer	44
wound repair (e.g. stitches)	44

2017 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	81
Female	97

**Age**
From 65 to 74	84
From 75 to 84	52
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2017

Hypertension	59
High Cholesterol	39
Stroke	0
Ischemic Heart Disease	27
Depression	14
Chronic Kidney Disease	23
Asthma	8
Osteoperosis	8
Atrial Fibrilation	11
Heart Failure	12
Chronic Obstructive Pulmonary Disease	12
Diabetes	19
Dementia	8
Cancer	12

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2018 were removal of lesion (e.g. growth), skin surgery, skin procedures and cancer surgery.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	85
doctor visit	103
plastic surgery procedures	48
reconstructive surgery	48
removal of lesion (e.g. growth)	85
skin procedures	85
skin surgery	85
tissue transfer	48
wound repair (e.g. stitches)	48

2018 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	109
Female	141

**Ethnicity**
Non-Hispanic White	233
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	128
From 75 to 84	82
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2018

Hypertension	53
High Cholesterol	43
Stroke	0
Ischemic Heart Disease	25
Depression	15
Chronic Kidney Disease	22
Asthma	5
Osteoperosis	11
Atrial Fibrilation	13
Heart Failure	10
Chronic Obstructive Pulmonary Disease	8
Diabetes	17
Dementia	7
Cancer	9

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2019 were removal of lesion (e.g. growth), skin procedures, reconstructive surgery and plastic surgery procedures.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	84
doctor visit	169
plastic surgery procedures	122
reconstructive surgery	122
removal of lesion (e.g. growth)	137
skin procedures	137
skin surgery	84
tissue transfer	122
wound repair (e.g. stitches)	122

2019 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	126
Female	179

**Ethnicity**
Non-Hispanic White	290
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	139
From 75 to 84	109
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2019

Hypertension	52
High Cholesterol	45
Stroke	0
Ischemic Heart Disease	24
Depression	12
Chronic Kidney Disease	20
Asthma	5
Osteoperosis	9
Atrial Fibrilation	11
Heart Failure	9
Chronic Obstructive Pulmonary Disease	6
Diabetes	18
Dementia	8
Cancer	9

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2020 were removal of lesion (e.g. growth), skin procedures, skin surgery and cancer surgery.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	135
doctor visit	107
plastic surgery procedures	85
reconstructive surgery	85
removal of lesion (e.g. growth)	177
skin procedures	177
skin surgery	135
tissue transfer	85
wound repair (e.g. stitches)	85

2020 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	96
Female	114

**Age**
From 65 to 74	89
From 75 to 84	84
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2020

Hypertension	48
High Cholesterol	44
Stroke	0
Ischemic Heart Disease	21
Depression	14
Chronic Kidney Disease	18
Asthma	0
Osteoperosis	0
Atrial Fibrilation	12
Heart Failure	10
Chronic Obstructive Pulmonary Disease	0
Diabetes	19
Dementia	6
Cancer	11

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2021 were removal of lesion (e.g. growth), skin procedures, skin surgery and cancer surgery.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	167
doctor visit	141
plastic surgery procedures	160
reconstructive surgery	160
removal of lesion (e.g. growth)	206
skin procedures	206
skin surgery	167
tissue transfer	160
wound repair (e.g. stitches)	160

2021 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	135
Female	119

**Ethnicity**
Non-Hispanic White	243
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	125
From 75 to 84	79
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2021

Hypertension	49
High Cholesterol	47
Stroke	0
Ischemic Heart Disease	26
Depression	14
Chronic Kidney Disease	14
Asthma	0
Osteoperosis	8
Atrial Fibrilation	11
Heart Failure	13
Chronic Obstructive Pulmonary Disease	5
Diabetes	14
Dementia	7
Cancer	12

Medicare Procedure and Patient Information

2022 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2022 were removal of lesion (e.g. growth), skin procedures, skin surgery and cancer surgery.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	200
doctor visit	432
plastic surgery procedures	191
reconstructive surgery	191
removal of lesion (e.g. growth)	451
skin procedures	451
skin surgery	200
tissue transfer	191
wound repair (e.g. stitches)	191

2022 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	166
Female	219

**Ethnicity**
Non-Hispanic White	365
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	174
From 75 to 84	138
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2022

Hypertension	61
High Cholesterol	64
Stroke	8
Ischemic Heart Disease	21
Depression	13
Chronic Kidney Disease	14
Asthma	6
Osteoperosis	14
Atrial Fibrilation	17
Heart Failure	10
Chronic Obstructive Pulmonary Disease	8
Diabetes	15
Dementia	4
Cancer	14

Medicare Procedure and Patient Information

2023 Medicare Procedure Volume

The top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA during 2023 were reconstructive surgery, plastic surgery procedures, wound repair (e.g. stitches) and tissue transfer.

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

cancer surgery	104
doctor visit	112
plastic surgery procedures	200
reconstructive surgery	200
removal of lesion (e.g. growth)	180
skin procedures	180
skin surgery	104
tissue transfer	200
wound repair (e.g. stitches)	200

2023 Medicare Patient Data

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Male	141
Female	157

**Ethnicity**
Non-Hispanic White	284
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	113
From 75 to 84	124
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD in 2023

Hypertension	60
High Cholesterol	71
Stroke	6
Ischemic Heart Disease	22
Depression	16
Chronic Kidney Disease	15
Asthma	9
Osteoperosis	13
Atrial Fibrilation	22
Heart Failure	13
Chronic Obstructive Pulmonary Disease	8
Diabetes	13
Dementia	4
Cancer	14

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2012 - 2023

Volume of procedures performed by Dr. Victor R. Michalak, MD for Medicare patients.

The highest averages for the top procedures that Dr. Victor R. Michalak, MD treated as a dermatologist in Issaquah, WA were removal of lesion (e.g. growth), skin procedures, reconstructive surgery and plastic surgery procedures.

cancer surgery	80
doctor visit	119
plastic surgery procedures	81
reconstructive surgery	81
removal of lesion (e.g. growth)	119
skin procedures	119
skin surgery	80
tissue transfer	81
wound repair (e.g. stitches)	81

Average Medicare Patient Data From 2012 - 2023

Information about Medicare patients treated by Dr. Victor R. Michalak, MD.

**Gender**
Female	111
Male	95

**Ethnicity**
Black / African American	0
Asian / Pacific Islander	0
Non-Hispanic White	117
Hispanic	0
Native American / Alaskan Native	0
Other	0

**Age**
85 and over	0
75 to 84	75
Less than 65	0
65 to 74	91

Average of Total of Conditions of Medicare patients treated by Dr. Victor R. Michalak, MD From 2012 - 2023

The highest averages of the most common conditions of Medicare patients that Dr. Victor R. Michalak, MD treated were hypertension, high cholesterol, ischemic heart disease and diabetes.

Hypertension	49
High Cholesterol	44
Stroke	1
Ischemic Heart Disease	22
Depression	13
Chronic Kidney Disease	15
Asthma	3
Osteoporosis	5
Heart Failure	8
Chronic Obstructive Pulmonary Disease	3
Diabetes	16
Atrial Fibrillation	13
Dementia	4
Cancer	9

Education & Training

Dr. Victor R. Michalak, MD graduated from Weill Cornell Medical College in 1983. He completed residency at Mayo Clinic. He is certified by the Board Certified in Dermatology and has a state license in Washington.

Medical School: Weill Cornell Medical College (1983)

Residency: Mayo Clinic

Board Certification: Board Certified in Dermatology

Licensed In: Washington

Affiliations & Hospitals

Dr. Victor R. Michalak, MD is associated with these hospitals and organizations:

Swedish Medical Center

Providence

Evergreen Health

Insurance Information

Please note: Insurance information may change at any time, and the provider may accept your insurance plan even if it is not listed below. Please contact the provider's office to confirm that your insurance is accepted.

Dr. Victor R. Michalak, MD appears to accept the following insurance providers: Aetna PPO and CIGNA PPO.

Insurance Accepted by Provider includes:

According to our sources, Dr. Victor R. Michalak, MD accepts the following insurance providers:

Aetna PPO

CIGNA PPO

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General Payments

These charts describe general payments received by Dr. Victor R. Michalak, MD. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.

**Payments by Company**
Biofrontera Inc.	$864 BF-RhodoLED $840	xepi $24
Allergan Inc.	$560 ACZONE $48	BOTOX COSMETIC $45	$466
AbbVie Inc.	$472 Skyrizi $340	Humira $64	BOTOX $51	$18
GENZYME CORPORATION	$422 DUPIXENT $403	$20
Galderma Laboratories, L.P.	$183 SOOLANTRA $16	EPIDUO FORTE $14	$153
Other	$899 Otezla $184	OLUMIANT $113	DUPIXENT DUPILUMAB INJECTION $100	DUPIXENT $54	Tremfya $44	Other $403

**Types of Payments**
Food and Beverage	$2,649
Honoraria	$700
Education	$51

Biography

Dr. Victor Michalak practices dermatology (skin disorders) in Issaquah, WA. Dr. Michalak's areas of expertise include dermabrasion, onabotulinumtoxinA (botox, botox cosmetic), and angiosarcoma. He takes Cigna, Aetna, and CIGNA Plans, in addition to other insurance carriers. After completing medical school at Weill Cornell Medical College, he performed his residency at Mayo Clinic. He is professionally affiliated with Providence and Swedish Issaquah Campus. According to Swedish Medical Center, new patients are welcome to contact Dr. Michalak's office in Issaquah, WA.