Organization
CENTRAL OREGON DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI HANEY RHIT (OFFICE MANAGER)
(541) 323-2181
Entity
Organization
Contact information
Practice address
388 SW BLUFF DR, BEND, OR 97702-1360
(541) 678-0020
(541) 383-2174
Mailing address
388 SW BLUFF DR, BEND, OR 97702-1360
(541) 678-0020
(541) 383-2174
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MD26648
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609815166
NPI (INDIVIDUAL)
OR
05
—
241835
—
OR
01
—
MD26648
LICENSE
OR
Enumeration date
05/31/2008
Last updated
03/07/2023
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