Organization
LAKE OSWEGO DERMATOLOGY GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA SHIGETA II (OFFICE MANAGER)
(503) 635-9221
Entity
Organization
Contact information
Practice address
17704 JEAN WAY, SUITE 102, LAKE OSWEGO, OR 97035-5497
(503) 635-9221
(503) 635-5902
Mailing address
17704 JEAN WAY, SUITE 102, LAKE OSWEGO, OR 97035-5497
(503) 635-9221
(503) 635-5902
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/08/2007
Last updated
02/03/2010
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