Portland Dermatology Clinic, LLP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD18952 Issued in OR

Legal business name

PORTLAND DERMATOLOGY CLINIC, LLP

Practice address

1414 NW Northrup St
Suite 600
Portland, OR 97209-2798

Phone

(503) 223-3104

Fax

(503) 223-4619

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Kate A Othus, MHA

Title

Administrator

Phone

(503) 445-2133

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Lisa S Turner, MD

  • Dermatology Physician
  • Portland, OR
  • NPI 1093731093
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279497600000",
    "number": "1740334952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 NW NORTHRUP ST",
            "address_2": "SUITE 600",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092798",
            "telephone_number": "503-223-3104",
            "fax_number": "503-223-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 NW NORTHRUP ST",
            "address_2": "SUITE 600",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092798",
            "telephone_number": "503-223-3104",
            "fax_number": "503-223-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND DERMATOLOGY CLINIC, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2010-07-19",
        "status": "A",
        "authorized_official_last_name": "OTHUS",
        "authorized_official_first_name": "KATE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-445-2133",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD18952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portland Dental Associates PC
• Portland Dental Center
• Portland Dental LLC
• Portland Dental Smiles
• Portland Dental Works, LLC
• Portland Detox
• Portland Diabetes & Endocrinology
• Portland Dialectical Behavior Therapy PC
• Portland Doctor, LLC
• Portland Dysphagia Diagnostics LLC

• Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.