LAKE OSWEGO DERMATOLOGY GROUP, PC
NPI 1710167689
Dermatology in Lake Oswego, OR

Active since November 08, 2007CLIA 38D0698929 · Certificate of Compliance
17704 JEAN WAY, SUITE 102, LAKE OSWEGO, OR 97035(503) 635-9221(503) 635-5902 Get Directions Write a Review

NPPES record last updated: February 3, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lake Oswego Dermatology Group, Pc NPPES

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

LAKE OSWEGO DERMATOLOGY GROUP, PC (NPI 1710167689) is a healthcare organization registered as a dermatology in Lake Oswego, Oregon and active in the NPI registry since November 2007. The organization holds a CLIA Certificate of Compliance certificate valid through November 28, 2026 and lists Rita Shigeta, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1710167689
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLAKE OSWEGO DERMATOLOGY GROUP, PC
Location Address17704 JEAN WAY, SUITE 102Lake Oswego, OR 97035-5497
Mailing Address17704 Jean Way, Suite 102Lake Oswego, OR 97035-5497 · (503) 635-9221 · Fax (503) 635-5902
Fax(503) 635-5902
Organization SubpartNo
Authorized OfficialRita ShigetaOffice Manager · (503) 635-9221
Enumeration DateNovember 8, 2007
Last NPPES UpdateFebruary 3, 2010
NPI 1710167689 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.
17704 JEAN WAY, Lake Oswego, OR 97035

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

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 38D0698929

Lake Oswego Dermatology Group Laboratory · Lake Oswego, OR
Active · expires Nov 28, 2026
CLIA Number38D0698929
Laboratory TypePhysician Office
Certificate Effective DateNovember 29, 2024
Certificate Expiration DateNovember 28, 2026
Laboratory DirectorDr. Andrew E. Pitt MD
Laboratory Phone(503) 635-9221
Laboratory LocationLake Oswego Dermatology Group Laboratory17704 Jean Way Suite 102, Lake Oswego, OR 97035
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 18

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

Internal Medicine
17704 JEAN WAY, SUITE 105
LAKE OSWEGO, OR 97035
Otolaryngology
17704 JEAN WAY, STE 101
LAKE OSWEGO, OR 97035
Nurse Practitioner (Adult Health)
17704 JEAN WAY, 105
LAKE OSWEGO, OR 97035
Internal Medicine
17704 JEAN WAY, SUITE 105
LAKE OSWEGO, OR 97035
Otolaryngology (Otology & Neurotology)
17704 JEAN WAY
LAKE OSWEGO, OR 97035
Physician Assistant
17704 JEAN WAY, STE 101
LAKE OSWEGO, OR 97035
Dermatology
17704 JEAN WAY, SUITE 102
LAKE OSWEGO, OR 97035
Otolaryngology
17704 JEAN WAY, STE 101
LAKE OSWEGO, OR 97035

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 Lake Oswego Dermatology Group, PC's NPI number?

The NPI number for Lake Oswego Dermatology Group, PC is 1710167689. It was assigned to this organization in the NPPES registry on November 8, 2007.

Where is Lake Oswego Dermatology Group, PC located?

Lake Oswego Dermatology Group, PC is located at 17704 Jean Way Suite 102, Lake Oswego, OR 97035. The listed phone number is (503) 635-9221.

What is Lake Oswego Dermatology Group, PC's specialty?

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

Does Lake Oswego Dermatology Group, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 38D0698929) is associated with this NPI, valid through November 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Oswego Dermatology Group, PC accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Lake Oswego Dermatology Group, 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 Lake Oswego Dermatology Group, PC was last updated on February 3, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.