NPI 1063109403 · live from the CMS NPI Registry
Elijah Jonathan Horesh, MD MPH
Dermatology in Portland, OR. National Provider Identifier 1063109403, active.
NPI record
| NPI | 1063109403 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 3303 S Bond Ave # Ch16d, Portland, OR 97239 |
| Practice phone | 503-494-1375 |
| Enumerated | April 18, 2023 |
| Last updated | March 19, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | PG227313 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.