NORTHWEST DERMATOLOGY & LASER CLINIC PC
Organization (NPI-2)
Active
Dermatology
Provider Information
- NPI Number
1376571364- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1130 NW 22ND AVE STE 330, PORTLAND, OR, 972102970
- Phone
- (503) 295-2366
- Fax
- (503) 295-3065
Specialties & Taxonomies
Dermatology
Primary License: OR #MD14681