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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