Organization
WILLAMETTE DERMATOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL A KLAS M.D. (OWNER/PHYSICIAN)
(503) 691-1743
Entity
Organization
Contact information
Practice address
19875 SW 65TH AVE, SUITE 260, TUALATIN, OR 97062-8353
(503) 691-1743
(503) 691-0983
Mailing address
PO BOX 23200, PORTLAND, OR 97281-3200
(503) 691-1743
(503) 691-0983
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD21432
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508999152
INDIVIDUAL PROVIDER NPI
OR
05
—
151278
—
OR
01
—
DG7086
RAILROAD MEDICARE
OR
Enumeration date
11/01/2005
Last updated
12/08/2008
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