NPI 1659144111 · live from the CMS NPI Registry
Genesis Dermatology
Dermatology in La Grande, OR. National Provider Identifier 1659144111, active.
NPI record
| NPI | 1659144111 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 1902 4th St Ste 3, La Grande, OR 97850 |
| Practice phone | 541-663-0007 |
| Enumerated | November 6, 2023 |
| Last updated | November 6, 2023 |
| Authorized official | Bryce Earle, Chief Operations Manager |
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.