Lila Derickson, ND

Primary specialty

NaturopathTaxonomy code 175F00000X

License

4181 Issued in OR

Practice address

4035 SE 52ND Ave Ste B
Portland, OR 97206

Phone

(503) 447-7757

Fax

(503) 436-7072

NPI assigned

Sep 18, 2018

Last updated

Oct 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1952885758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 SE 52ND AVE STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972063913",
            "telephone_number": "503-447-7757",
            "fax_number": "503-436-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 SE 52ND AVE STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97206",
            "telephone_number": "503-447-7757",
            "fax_number": "503-436-7072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 NE 19th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322829",
            "country_code": "US",
            "telephone_number": "503-239-8181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERICKSON",
        "first_name": "LILA",
        "credential": "ND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "4181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Stuart Derby, MD
• Shannon Derbyshire, DC
• Genevieve N Derenne, OTR
• Ebisa Deressa
• Paul Doug Derham, CADC-R
• George Derk, MD
• Gwendolyn Rose Derk
• Dermatology by Design LLC
• Dermatology Professionals
• Craig Scott Dermer, CCC-CLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.