Organization · Type 2 NPI

Providence Health & Services - Oregon

Dermatology Physician · Portland, OR

NPI number 1083714141 Active

Practice location

417 SW 117th Ave, 2nd Floor
Portland, OR 97225-5924

Call (503) 216-9400 Map

Fax (503) 216-9499

Mailing address

PO Box 31001 - 4180
Pasadena, CA 91110-4180

Specialties and licenses

TaxonomyCodeLicense
Dermatology Physician Primary 207N00000XNone listed
Clinic/Center 261Q00000XNone listed

Dermatology Physician: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis an…

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About NPI 1083714141

Providence Health & Services - Oregon's National Provider Identifier is 1083714141, issued on Sep 25, 2006. The primary taxonomy on file is Dermatology Physician (207N00000X), and the practice location is in Portland, OR. The record was last updated on Jun 20, 2025.