Organization
DERMATOLOGY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN GREENWADE (OFFICE MANAGER)
(503) 588-0469
Entity
Organization
Contact information
Practice address
2441 GREAR ST NE, SALEM, OR 97301-2749
(503) 364-3321
Mailing address
2441 GREAR ST NE, SALEM, OR 97301-2749
(503) 364-3321
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046573
—
OR
Enumeration date
03/29/2006
Last updated
02/04/2010
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