Clear Choice Dermatology

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

Legal business name

CLEAR CHOICE DERMATOLOGY

Practice address

1610 12TH St SE
Salem, OR 97302-2821

Phone

(541) 316-6575

Fax

(541) 210-8913

NPI assigned

Mar 27, 2024

Organization subpart

Yes

Parent organization

CLEAR CHOICE DERMATOLOGYAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Collin Matthew Blattner, DONPI 1669868493

Title

Owner

Phone

(602) 228-1967

Specialties & licenses 1

Addresses

Other names 1

• CC Dermpath Lab Other name

Part of

Clear Choice Dermatology

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Clear Choice Dermatology

  • Dermatology Physician
  • The Dalles, OR
  • NPI 1891327185
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Collin Matthew Blattner, D.O.

  • Dermatology Physician
  • The Dalles, OR
  • NPI 1669868493
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1316797640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2430",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970588022",
            "telephone_number": "541-316-6575",
            "fax_number": "541-210-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 12TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022821",
            "telephone_number": "541-316-6575",
            "fax_number": "541-210-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR CHOICE DERMATOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLEAR CHOICE DERMATOLOGY",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "BLATTNER",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-228-1967",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CC Dermpath Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Claudia L Rodriguez
• Angela Clausen
• Kristin Nichole Clausen, PA-C
• Arvilla Marie Claussen, PMHNP
• James E Clay, PSYD DOCTOR OF PSYCH
• Clearview Counseling
• Clearview Counseling Center, LLC
• Caitlyn Cleary
• Judith Cleave, R.N.
• Jennifer Lynn Clemens, DMD

• Dermatopathology (Pathology) Physician in Salem, OR
• Providers in Salem, OR by specialty
• Dermatopathology (Pathology) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.