| NPI | 1134375421 |
|---|---|
| Former Legal Business Name | SILVER FALLS DERMATOLOGY, PC |
| Entity Type | Organization |
| Authorized Contact | RUSSELL JOHN YOUNG President 503-362-8385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OR MD26178) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2021-03-12 |