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Organization
SKIN CANCER SURGERY CENTER
Active
Organization
SKIN CANCER SURGERY CENTER
Active
Other names
Skin Cancer Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA PENA (CLINIC MANAGER)
(503) 691-1122
Entity
Organization
Contact information
Practice address
6370 SW BORLAND RD., SUITE 200, TUALATIN, OR 97062
(503) 691-1122
(503) 691-1144
Mailing address
6370 SW BORLAND RD., SUITE 200, TUALATIN, OR 97062
(503) 691-1122
(503) 691-1144
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
23409
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287107
—
OR
Enumeration date
02/19/2008
Last updated
01/11/2024
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