DERMATOLOGY NORTHWEST LLC (NPI# 1922365956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922365956 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY NORTHWEST LLC |
| Practice Address |
5900 Inland Shores Way N Ste 202 Keizer OR 97303-3883 |
| Mailing Address |
5900 Inland Shores Way Ste 202 Keizer OR 97303 |
| Practice Telephone | 5034636799 |
| Practice Fax Number | 5034636771 |
| Mailing Telephone | 5034636799 |
| Mailing Fax Number | 5034636771 |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2012-04-16 |
| Authorized Official Name | TERI L LITKE (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 5034636799 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD10836 | OR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790956415 | Dermatology Northwest LLC | Dermatology | 1845 W Orange Grove Rd, Suite 101, Tucson, AZ 85704-1134 | 2008-03-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | DERMATOLOGY NORTHWEST LLC | 5900 Inland Shores Way, Ste 202, Keizer, OR 97303 |
| Street Address |
5900 INLAND SHORES WAY N STE 202 |
| City | KEIZER |
| State | OR |
| Zip Code | 97303-3883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801859764 | Barbara N Foulke | Nurse Practitioner | 5900 Inland Shores Way N, Keizer, OR 97303-3795 | 2006-04-10 |
| 1730310830 | Nirmal Bastola | Family Medicine | 5900 Inland Shores Way N, Keizer, OR 97303-3883 | 2009-08-06 |
| 1982850152 | Rishi Pathak | Family Medicine | 5900 Inland Shores Way N, Keizer, OR 97303-3883 | 2008-08-07 |
| 1992973622 | Salem Clinic, PC | General Practice | 5900 Inland Shores Way N, Keizer, OR 97303-3795 | 2008-02-15 |
| 1245355643 | Johan Kohler | Family Medicine | 5900 Inland Shores Way N, Keizer, OR 97303-3795 | 2007-03-21 |
| 1336183474 | Lesley E Garber | Family Medicine | 5900 Inland Shores Way N, Keizer, OR 97303-3883 | 2006-06-16 |
| 1336183599 | Anne A Nunes | Family Medicine | 5900 Inland Shores Way N, Keizer, OR 97303-3883 | 2006-06-16 |
| 1881638310 | Stephen A Carp | Internal Medicine | 5900 Inland Shores Way N, Keizer, OR 97303-3883 | 2006-06-15 |
| 1730123308 | Jeffrey T Wang | Internal Medicine | 5900 Inland Shores Way N, Keizer, OR 97303-3883 | 2006-06-15 |
| 1538103916 | Fred G Foulke | Family Medicine | 5900 Inland Shores Way N, Keizer, OR 97303-3883 | 2006-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649750175 | Kristin Marie Barz | Behavioral Analyst | 4690 12th Ave Ne, Keizer, OR 97303 | 2018-08-15 |
| 1003359605 | Angela Rose Richard | Community Health Worker | 3410 Cherry Avenue Ne, Keizer, OR 97303 | 2016-11-30 |
| 1881146629 | Alma Denise Vera | Dental Hygienist | 5825 Shoreview Lane Ste C, Keizer, OR 97303 | 2016-10-27 |
| 1679919849 | Ramya Shyamala Kamath | Dentist | 4817 River Rd N, Keizer, OR 97303 | 2013-05-15 |
| 1356682041 | Teresa M Treinen | Physical Therapist | 190 Sandy Drive N, Keizer, OR 97303 | 2013-03-06 |
| 1598001844 | Eagle Eye Vision Care LLC | Optometrist | 4048 River Road North, Keizer, OR 97303 | 2012-12-13 |
| 1245590553 | Thora Jane Stacy | Dental Assistant | 2300 N.e. Lacncaster Dr., Salem, OR 97303 | 2012-05-21 |
| 1295028850 | Rodger Nordskog Magnuson | Pharmacist | 5452 River Road N., Keizer, OR 97303 | 2011-05-16 |
| 1326299843 | Douglas Scott Hamblin | Pediatrics | 5685 Inland Shores Way, Keizer, OR 97303 | 2008-10-02 |
| 1982870382 | Debra Kaye Lynch | Podiatrist | 4905 River Road N, Keizer, OR 97303 | 2008-05-06 |
| Find all providers in zip 97303 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962799833 | Trinity Sheraden | Specialist | 1085 Moneda Ave N, Keizer, OR 97303-6256 | 2011-06-29 |
| 1114135373 | Heather Nicole Howard | Specialist | 6020 Windsor Island Rd N., Keizer, OR 97303 | 2007-05-20 |
| 1740333574 | Carolyn I Hale | Specialist | 5900 Inland Shores Way N Ste 202, Keizer, OR 97303-3884 | 2007-01-18 |
| 1285074146 | Katherine M Cooper Compton | Specialist | 3855 River Rd N, Keizer, OR 97303-4803 | 2013-06-25 |
| 1770714115 | Nathan David Vanderburg | Specialist | 6395 Keizer Station Blvd Ne, Keizer, OR 97303-2305 | 2009-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536560 | Irina A Mcgaughey | Specialist | 610 Sw Alder St Ste 920, Portland, OR 97205-3610 | 2020-10-19 |
| 1780294181 | Cynthia R Mendoza | Specialist | 2245 Se Powell Blvd, Portland, OR 97202-2143 | 2020-07-31 |
| 1679199335 | Alter Image, Inc. | Specialist | 2340 Se Gladstone St, Portland, OR 97202-2962 | 2020-06-18 |
| 1922629328 | Yahsolait Rose | Specialist | 3575 Donald St Ste 170, Eugene, OR 97405-4783 | 2020-04-27 |
| 1225658560 | Leslie Ryan | Specialist | 377 Laclair St, Coos Bay, OR 97420-4709 | 2020-04-16 |
| 1780225474 | Katie Jane Clark | Specialist | 44 Industrial Way Ste D, Lebanon, OR 97355-4364 | 2019-10-03 |
| 1639727795 | Christina Bellmore | Specialist | 1748 Nw Fairview Dr # A, Gresham, OR 97030-3842 | 2019-08-30 |
| 1740841436 | Lacey Nicole Keeney | Specialist | 1623 Oak St, Eugene, OR 97401-4022 | 2019-06-24 |
| 1700347804 | Audrey Jones | Specialist | 16055 Boones Ferry Rd, Lake Oswego, OR 97035-4364 | 2019-03-29 |
| 1770044281 | Donnissa Smith | Specialist | 117 Se 129th Ave, Portland, OR 97233-1503 | 2019-03-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.