Organization Active NPI

DK Pathology

  • Clinical Medical Laboratory
  • Tualatin, OR
National Provider Identifier
1366710782
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
38D2032723 Issued in OR
Legal business name
DK PATHOLOGY
Practice address
6370 SW Borland Rd
Suite 206
Tualatin, OR 97062-9768
Phone
(503) 691-1122
NPI assigned
Dec 13, 2011
Last updated
Dec 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Authorized official

Name
David Clark
Title
Manager
Phone
(503) 691-1122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 38D2032723 OR Primary

Addresses

Primary practice location

6370 SW Borland Rd
Suite 206
Tualatin, OR 97062-9768

Mailing address

6370 SW Borland Rd
Suite 206
Tualatin, OR 97062-9768
Phone (503) 691-1122

Other identifiers 1

IdentifierTypeStateIssuer
38D2032723OtherORCLIA

National Provider Directory

National Provider Directory

Locations

6370 SW Borland Rd
Ste 206
Tualatin, OR 97062
Phone (503) 691-1122

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1366710782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6370 SW BORLAND RD",
            "address_2": "SUITE 206",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629768",
            "telephone_number": "503-691-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6370 SW BORLAND RD",
            "address_2": "SUITE 206",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629768",
            "telephone_number": "503-691-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DK PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-691-1122"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OR",
            "license": "38D2032723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "38D2032723",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.