Northwest Dermatology & Laser Clinic Pc
LBN: Northwest Dermatology & Laser Clinic Pc
Northwest Dermatology & Laser Clinic Pc is an health care organization with primary practice located at 1130 Nw 22Nd Ave Ste 330 , Portland OR 97210-2970. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty.
Northwest Dermatology & Laser Clinic Pc can be contacted via phone (503) 295-2366, or through Tavelli, Bert G via phone (503) 295-2366.
Contact Information
Primary practice address
1130 Nw 22Nd Ave Ste 330
Portland OR 97210-2970
Phone: (503) 295-2366
Fax: (503) 295-3065
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD14681 | Oregon |
Profile Details
| NPI number | 1376571364 |
|---|---|
| LBN Legal business name | Northwest Dermatology & Laser Clinic Pc |
| DBA Doing business as | |
| Authorized official | Tavelli, Bert G Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Jun 1st, 2016 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376571364 | NPPES |
| Oregon | Other | DD5356 | RAILROAD MEDICARE |
| Oregon | MEDICAID | 028071 | RAILROAD MEDICARE |
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