NPI 1902109887 · live from the CMS NPI Registry
Dermatology Professionals
Dermatology in Portland, OR. National Provider Identifier 1902109887, active.
NPI record
| NPI | 1902109887 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 2228 Lloyd Ctr, Suite 0h303, Portland, OR 97232 |
| Practice phone | 503-344-6643 |
| Mailing address | Po Box 28150, Portland, OR 97228 |
| Enumerated | December 14, 2010 |
| Last updated | March 20, 2012 |
| Authorized official | Claudia Taylor, Member/Owner |
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.