Organization
DERMATOLOGY NORTHWEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERI L LITKE (PRACTICE ADMINISTRATOR)
(503) 463-6799
Entity
Organization
Contact information
Practice address
5900 INLAND SHORES WAY N, STE 202, KEIZER, OR 97303-3883
(503) 463-6799
(503) 463-6771
Mailing address
5900 INLAND SHORES WAY, STE 202, KEIZER, OR 97303
(503) 463-6799
(503) 463-6771
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD10836
OR
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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