NORTHWEST DERMATOLOGY & LASER CLINIC PC

PORTLAND, OR
NPI1376571364
Entity TypeOrganization
Authorized ContactBERT G TAVELLI
President
503-295-2366
Organization Subpart ?No
Primary Taxonomy207N00000X Dermatology
(Licence: OR  MD14681)
Enumeration Date2006-06-29
Last Update Date2016-06-01
Business Address
NORTHWEST DERMATOLOGY & LASER CLINIC PC
1130 NW 22ND AVE STE 330
PORTLAND, OR 97210-2970
Phone number: 503-295-2366
Mailing Address
NORTHWEST DERMATOLOGY & LASER CLINIC PC
PO BOX 23200
PORTLAND, OR 97281-3200
Phone number: 503-968-4620
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