NPI 1174697239 · live from the CMS NPI Registry
Epiphany Dermatology Of Oregon, LLC
Dermatology in Portland, OR. National Provider Identifier 1174697239, active.
NPI record
| NPI | 1174697239 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 2222 Nw Lovejoy St, Suite 422, Portland, OR 97210 |
| Practice phone | 503-227-7117 |
| Mailing address | 7300 Ranch Road 2222, Bldg 1, Ste 200, Austin, TX 78730 |
| Enumerated | November 20, 2006 |
| Last updated | July 21, 2025 |
| Authorized official | Gheorghe Pusta, Secretary |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.