Organization
EPIPHANY DERMATOLOGY OF OREGON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (SECRETARY)
(512) 628-0465
Entity
Organization
Contact information
Practice address
2222 NW LOVEJOY ST, SUITE 422, PORTLAND, OR 97210-3033
(503) 227-7117
(503) 227-7120
Mailing address
7300 RANCH ROAD 2222, BLDG 1, STE 200, AUSTIN, TX 78730-3255
(512) 628-0465
(512) 233-2711
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/20/2006
Last updated
07/21/2025
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