Epiphany Dermatology Of Oregon, LLC
Dermatology in Portland, OR. Organization (NPI-2).
NPI number1174697239
StatusActive
Last updated in NPPESJul 21, 2025
Details
- NPI
- 1174697239
- Entity type
- Organization (NPI-2)
- Legal business name
- Epiphany Dermatology Of Oregon, LLC
- Organization subpart
- No
- Enumeration date
- Nov 20, 2006
- Certification date
- Jul 21, 2025
- Last updated
- Jul 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
Practice location
2222 Nw Lovejoy StSuite 422
Portland, OR 97210-3033
Phone 503-227-7117 · Fax 503-227-7120
Mailing address
7300 Ranch Road 2222, Bldg 1, Ste 200Austin, TX 78730-3255
Phone 512-628-0465 · Fax 512-233-2711
Authorized official
Gheorghe Pusta
Secretary
5126280465
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