Lake Oswego Dermatology Group, PC
NPI #1710167689 in Lake Oswego, Oregon
Provider Information
- NPI Number
- 1710167689
- Entity Type
- Organization
- Organization Name
- Lake Oswego Dermatology Group, PC
- Primary Specialty
- Dermatology
- Enumeration Date
- Nov 8, 2007
- Last Updated
- Feb 3, 2010
Practice Location
- Address
- 17704 JEAN WAY
- Address 2
- SUITE 102
- City
- Lake Oswego
- State
- Oregon
- ZIP Code
- 97035-5497
- Phone
- (503) 635-9221
Authorized Official
- Name
- RITA SHIGETA II
- Title
- OFFICE MANAGER
- Phone
- (503) 635-9221
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dermatology |
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