FAIR WINDS DERMATOLOGY LLC
NPI 1639937170
Dermatology in Corvallis, OR

Active since March 11, 2024CLIA 38D2260654 · Certificate of Compliance
2430 NW PROFESSIONAL DR, CORVALLIS, OR 97330(541) 230-1350 Get Directions Write a Review

NPPES record last updated: November 25, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fair Winds Dermatology Llc NPPES

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

FAIR WINDS DERMATOLOGY LLC (NPI 1639937170) is a healthcare organization registered as a dermatology in Corvallis, Oregon and active in the NPI registry since March 2024. The organization holds a CLIA Certificate of Compliance certificate valid through September 19, 2026 and lists Katie Hatsushi, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1639937170
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameFAIR WINDS DERMATOLOGY LLC
Location Address2430 NW PROFESSIONAL DRCorvallis, OR 97330-3991
Mailing Address2430 Nw Professional DrCorvallis, OR 97330-3991 · (541) 452-0180 · Fax (541) 427-4435
Organization SubpartNo
Authorized OfficialKatie HatsushiOffice Manager · (408) 480-7500
Enumeration DateMarch 11, 2024
Last NPPES UpdateNovember 25, 2024
NPPES CertifiedNovember 25, 2024
NPI 1639937170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.

2430 NW PROFESSIONAL DR, Corvallis, OR 97330

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

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 38D2260654

Fair Winds Dermatology LLC · Corvallis, OR
Active · expires Sep 19, 2026
CLIA Number38D2260654
Laboratory TypePhysician Office
Certificate Effective DateSeptember 20, 2024
Certificate Expiration DateSeptember 19, 2026
Laboratory DirectorCarrick T. Burns
Laboratory Phone(541) 452-0180
Laboratory LocationFair Winds Dermatology LLC2430 NW Professional Dr, Corvallis, OR 97330
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.

Other Providers at the Same Location NPPES

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

Dermatology
2430 NW PROFESSIONAL DR
CORVALLIS, OR 97330

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 Fair Winds Dermatology LLC's NPI number?

The NPI number for Fair Winds Dermatology LLC is 1639937170. It was assigned to this organization in the NPPES registry on March 11, 2024.

Where is Fair Winds Dermatology LLC located?

Fair Winds Dermatology LLC is located at 2430 NW Professional Dr, Corvallis, OR 97330. The listed phone number is (541) 230-1350.

What is Fair Winds Dermatology LLC's specialty?

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

Does Fair Winds Dermatology LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 38D2260654) is associated with this NPI, valid through September 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fair Winds Dermatology LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Fair Winds 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 Fair Winds Dermatology LLC was last updated on November 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.