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Organization

CLACKAMAS DERMATOLOGY PC

Active
Other names
Goodskin Dermatology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL JEFFERY ANDERUD D.O. (OWNER/CEO)
(503) 654-7546
Entity
Organization

Contact information

Practice address
12605 SE 97TH AVE, CLACKAMAS, OR 97015-9706
(503) 654-7546
(503) 786-3542
Mailing address
12605 SE 97TH AVE, CLACKAMAS, OR 97015-9706
(503) 654-7546
(503) 786-3542

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
DO157838
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500702253
OR
Enumeration date
05/08/2013
Last updated
05/25/2023
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