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SILVER FALLS DERMATOLOGY, LLC
NPI 1134375421
Dermatology in Salem, OR

Active since August 18, 2008CLIA Certified · 9 labs
1793 13TH ST SE, SALEM, OR 97302(503) 362-8385(503) 362-8435 Get Directions Write a Review

NPPES record last updated: October 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 12, 2021, Feb 25, 2020, Dec 23, 2019 and 3 more (6 updates tracked since 2017).

About Silver Falls Dermatology, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SILVER FALLS DERMATOLOGY, LLC (NPI 1134375421), doing business as Silver Falls Dermatology, Pc, is a healthcare organization registered as a dermatology in Salem, Oregon and active in the NPI registry since August 2008. The organization holds 9 active CLIA laboratory certificates and lists Malissa Kobbevik, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1134375421
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSILVER FALLS DERMATOLOGY, LLC
Location Address1793 13TH ST SESalem, OR 97302-2541
Mailing Address1793 13th St SeSalem, OR 97302-2541 · (503) 362-8385 · Fax (503) 362-8435
Phone(503) 362-8385
Fax(503) 362-8435
Organization SubpartNo
Authorized OfficialMalissa KobbevikCredentialing Manager · (360) 375-2038
Enumeration DateAugust 18, 2008
Last NPPES UpdateOctober 17, 20246 updates tracked since enumeration
NPPES CertifiedOctober 17, 2024
✔ NPI 1134375421 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in OR · MD26178
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
Also ListedDermatology · Clinical & Laboratory Dermatological ImmunologyTaxonomy 207NI0002X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
1793 13TH ST SE, Salem, OR 97302
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Other Names 2

Former Legal Business NameSilver Falls Dermatology, Pc
Doing Business AsFrontier Dermatology

Other Identifiers 2

Medicaid2034282WA
Medicaid247588OR

Group Practice 2

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 9

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 38D1058546

Silver Falls Dermatology PC · Salem, OR
Active · expires Feb 25, 2027
CLIA Number38D1058546
Laboratory TypePhysician Office
Certificate Effective DateFebruary 26, 2025
Certificate Expiration DateFebruary 25, 2027
Laboratory DirectorAngela Bohlke MD
Laboratory Phone(503) 362-8385
Laboratory LocationSilver Falls Dermatology PC1793 13th Street SE, Salem, OR 97302
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 50D2112068

Silver Falls Dermatology · Olympia, WA
Active · expires Apr 4, 2028
CLIA Number50D2112068
Laboratory TypePhysician Office
Certificate Effective DateSeptember 5, 2017
Certificate Expiration DateApril 4, 2028
Laboratory DirectorLaurie Jacobson
Laboratory Phone(503) 362-8385
Laboratory LocationSilver Falls Dermatology3825 Martin Way E Ste 104, Olympia, WA 98506
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 50D2136202

Silver Falls Dermatology · Vancouver, WA
Active · expires Apr 4, 2028
CLIA Number50D2136202
Laboratory TypePhysician Office
Certificate Effective DateSeptember 5, 2017
Certificate Expiration DateApril 4, 2028
Laboratory DirectorKean Lawlor
Laboratory Phone(503) 362-8385
Laboratory LocationSilver Falls Dermatology2415 NE 134th St Ste 107, Vancouver, WA 98686
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 50D2178832

Silver Falls Dermatology - Bellevue · Bellevue, WA
Active · expires Apr 4, 2028
CLIA Number50D2178832
Laboratory TypePhysician Office
Certificate Effective DateFebruary 10, 2020
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAlison Carrigg
Laboratory Phone(503) 362-8385
Laboratory LocationSilver Falls Dermatology - Bellevue1515 116th Ave NE Ste 104, Bellevue, WA 98004
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 38D1093601

Silver Falls Dermatology-Woodburn · Woodburn, OR
Active · expires Jan 1, 2028
CLIA Number38D1093601
Laboratory TypePhysician Office
Certificate Effective DateJanuary 2, 2026
Certificate Expiration DateJanuary 1, 2028
Laboratory DirectorAlison Carrigg
Laboratory Phone(503) 362-8385
Laboratory LocationSilver Falls Dermatology-Woodburn685 Evergreen Road NE, Woodburn, OR 97071
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 38D2110297

Silver Falls Dermatology Astoria · Astoria, OR
Active · expires Oct 16, 2027
CLIA Number38D2110297
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorAngela Bohlke MD
Laboratory Phone(503) 362-8385
Laboratory LocationSilver Falls Dermatology Astoria2120 Exchange St Suite 202, Astoria, OR 97103
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. DEBORAH PREKKER JONES FNP-C
Nurse Practitioner (Family)
1793 13TH ST SE
SALEM, OR 97302
Marion County (503) 362-8385
DR. RICK DEWITT PITTMAN MD
Surgery (Vascular Surgery)
1793 13TH ST SE
SALEM, OR 97302
Marion County (503) 362-8385
DR. RUSSELL JOHN YOUNG MD
Dermatology
1793 13TH ST SE
SALEM, OR 97302
Marion County (503) 362-8385
DR. SARAH E SHANGRAW MD
Dermatology
1793 13TH ST SE
SALEM, OR 97302
Marion County (503) 362-8385
ARMAAN GURAYA DO
Student in an Organized Health Care Education/Training Program
1793 13TH ST SE
SALEM, OR 97302
Marion County (503) 362-8385
LAUREN GENE WILLIAMS FNP
Nurse Practitioner
1793 13TH ST SE
SALEM, OR 97302
Marion County (503) 362-8385
MR. MARK D. WILLIAMS PA-C
Physician Assistant
1793 13TH ST SE
SALEM, OR 97302
Marion County (503) 362-8385
BROLIN JOHNSON PA
Physician Assistant (Medical)
1793 13TH ST SE
SALEM, OR 97302
Marion County (503) 362-8385

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Silver Falls Dermatology, LLC's NPI number?

The NPI number for Silver Falls Dermatology, LLC is 1134375421. It was assigned to this organization in the NPPES registry on August 18, 2008. The provider is doing business as Frontier Dermatology. The provider was formerly known as Silver Falls Dermatology, PC.

Where is Silver Falls Dermatology, LLC located?

Silver Falls Dermatology, LLC is located at 1793 13th St SE, Salem, OR 97302. The listed phone number is (503) 362-8385.

What is Silver Falls Dermatology, LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Silver Falls Dermatology, LLC hold CLIA laboratory certificates?

Yes. 9 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Silver Falls Dermatology, LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska and Regence BlueCross BlueShield of Oregon list Silver Falls Dermatology, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Silver Falls Dermatology, LLC was last updated on October 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.