NPI 1194110288 · live from the CMS NPI Registry
Betty Si Yuan Jiang
Dermatology in Lake Oswego, OR. National Provider Identifier 1194110288, active.
NPI record
| NPI | 1194110288 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 17704 Jean Way Ste 102, Lake Oswego, OR 97035 |
| Practice phone | 503-635-9221 |
| Enumerated | April 6, 2015 |
| Last updated | September 5, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | 175989 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.