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GOODSKIN DERMATOLOGY
NPI 1700221397
Dermatology in Clackamas, OR

Active since May 08, 2013CLIA Certified · 4 labs
12605 SE 97TH AVE, CLACKAMAS, OR 97015(503) 654-7546(503) 786-3542 Get Directions Write a Review

NPPES record last updated: May 25, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Goodskin Dermatology NPPES

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

GOODSKIN DERMATOLOGY (NPI 1700221397) is a healthcare organization registered as a dermatology in Clackamas, Oregon and active in the NPI registry since May 2013. The organization holds 4 active CLIA laboratory certificates and lists Paul Jeffery Anderud, Owner/ceo, as its authorized official.

NPPES Registry Identity

NPI1700221397
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCLACKAMAS DERMATOLOGY PC
Location Address12605 SE 97TH AVEClackamas, OR 97015-9706
Mailing Address12605 Se 97th AveClackamas, OR 97015-9706 · (503) 654-7546 · Fax (503) 786-3542
Phone(503) 654-7546
Fax(503) 786-3542
Organization SubpartNo
Authorized OfficialPaul Jeffery AnderudOwner/ceo · (503) 654-7546
Enumeration DateMay 8, 2013
Last NPPES UpdateMay 25, 2023
NPPES CertifiedMay 25, 2023
✔ NPI 1700221397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in OR · DO157838
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.
12605 SE 97TH AVE, Clackamas, OR 97015
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Other Names 1

Doing Business AsGoodskin Dermatology

Other Identifiers 1

Medicaid500702253OR

Group Practice 1

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., Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Goodskin Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Goodskin Dermatology, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Danielle Mcclanahan, M.D.
Dermatology
NPI 1851880876
12605 SE 97TH AVE
Clackamas, OR 97015
(503) 654-7546
✔ PECOS✔ Accepts MedicareSame address
Paul Aanderud, D.O.
Dermatology
NPI 1255569273
9775 SE SUNNYSIDE RD STE 500
Clackamas, OR 97015
(503) 654-7546
✔ PECOS✔ Accepts Medicare0.2 mi
Jessica Nappier, FNP
Nurse Practitioner
NPI 1003515560
2127 NW MILLER RD STE A
Portland, OR 97229
(503) 902-4770
✔ PECOS13 mi
Alexis Buffington, DO
Dermatology
NPI 1407389406
18101 OAKWOOD BLVD
Dearborn, MI 48124
(313) 436-2581
✔ PECOS✔ Accepts Medicare1,958 mi
Karl Vance
Dermatology
NPI 1922234780
1356 LUSITANA ST FL 7
Honolulu, HI 96813
(808) 586-2910
✔ PECOS✔ Accepts Medicare2,597 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 4

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 38D0624574

Clackamas Dermatology · Clackamas, OR
Active · expires Aug 6, 2027
CLIA Number38D0624574
Laboratory TypePhysician Office
Certificate Effective DateAugust 7, 2025
Certificate Expiration DateAugust 6, 2027
Laboratory DirectorPaul J. Aanderud
Laboratory Phone(503) 654-7546
Laboratory LocationClackamas Dermatology12605 SE 97th Ave, Clackamas, OR 97015
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 38D2178305

Clackamas Dermatology, PC - Goodskin Dermatology · Beaverton, OR
Active · expires Mar 24, 2028
CLIA Number38D2178305
Laboratory TypePhysician Office
Certificate Effective DateMarch 25, 2026
Certificate Expiration DateMarch 24, 2028
Laboratory DirectorPaul J. Aanderud
Laboratory Phone(503) 654-7546
Laboratory LocationClackamas Dermatology, PC - Goodskin Dermatology2935 SW Cedar Hills Blvd, Beaverton, OR 97005
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) 38D2167388

Clackamas Dermatology - Troutdale · Troutdale, OR
Active · expires Jun 5, 2027
CLIA Number38D2167388
Laboratory TypePhysician Office
Certificate Effective DateJune 6, 2025
Certificate Expiration DateJune 5, 2027
Laboratory DirectorPaul J. Aanderud
Laboratory Phone(503) 654-7546
Laboratory LocationClackamas Dermatology - Troutdale1620 SW 257th Avenue, Troutdale, OR 97060
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 of Compliance 38D0856422

Clackamas Dermatology PC - Hillsboro Dba Goodskin Dermatology · Hillsboro, OR
Active · expires Mar 12, 2027
CLIA Number38D0856422
Laboratory TypePhysician Office
Certificate Effective DateMarch 13, 2025
Certificate Expiration DateMarch 12, 2027
Laboratory DirectorDr. Paul J. Aanderud
Laboratory Phone(503) 654-7546
Laboratory LocationClackamas Dermatology PC - Hillsboro Dba Goodskin Dermatology545 SE Oak Street Suite B, Hillsboro, OR 97123
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.

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 Clackamas Dermatology PC's NPI number?

The NPI number for Clackamas Dermatology PC is 1700221397. It was assigned to this organization in the NPPES registry on May 8, 2013. The provider is doing business as Goodskin Dermatology.

Where is Clackamas Dermatology PC located?

Clackamas Dermatology PC is located at 12605 SE 97th Ave, Clackamas, OR 97015. The listed phone number is (503) 654-7546.

What is Clackamas Dermatology PC's specialty?

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

Is Clackamas Dermatology PC enrolled in Medicare?

Yes. Clackamas Dermatology PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Clackamas Dermatology PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Clackamas Dermatology PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (4) and Nurse Practitioner (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Clackamas Dermatology PC hold CLIA laboratory certificates?

Yes. 4 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 Clackamas Dermatology PC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Clackamas Dermatology PC 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 Clackamas Dermatology PC was last updated on May 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.