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KNOTT STREET DERMATOLOGY PC
NPI 1891741864
Specialist in Portland, OR

Active since May 25, 2006CLIA Certified · 2 labs
301 NE KNOTT ST, PORTLAND, OR 97212(503) 253-2675(503) 253-4297 Get Directions Write a Review

NPPES record last updated: August 13, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Knott Street Dermatology Pc NPPES

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

KNOTT STREET DERMATOLOGY PC (NPI 1891741864) is a healthcare organization registered as a specialist in Portland, Oregon and active in the NPI registry since May 2006. The organization holds 2 active CLIA laboratory certificates and lists Eric Leif Hanson, President, as its authorized official.

NPPES Registry Identity

NPI1891741864
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameKNOTT STREET DERMATOLOGY PC
Location Address301 NE KNOTT STPortland, OR 97212-3014
Mailing Address301 Ne Knott StPortland, OR 97212-3014 · (503) 253-2675 · Fax (503) 253-4297
Phone(503) 253-2675
Fax(503) 253-4297
Organization SubpartNo
Authorized OfficialEric Leif HansonPresident · (503) 253-3910
Enumeration DateMay 25, 2006
Last NPPES UpdateAugust 13, 2014
✔ NPI 1891741864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in OR · MD26393
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
301 NE KNOTT ST, Portland, OR 97212
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINH61417
Medicare PINR134757OR

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., Providence Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 38D1056877

Knott Street Dermatology PC · Portland, OR
Active · expires Oct 10, 2026
CLIA Number38D1056877
Laboratory TypePhysician Office
Certificate Effective DateOctober 11, 2024
Certificate Expiration DateOctober 10, 2026
Laboratory DirectorEric L. Hanson
Laboratory Phone(503) 253-3910
Laboratory LocationKnott Street Dermatology PC301 NE Knott Street, Portland, OR 97212
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 for Provider-Performed Microscopy Procedures (PPMP) 38D1091271

Knott Street Dermatology · Milwaukie, OR
Active · expires Oct 8, 2027
CLIA Number38D1091271
Laboratory TypePhysician Office
Certificate Effective DateOctober 9, 2025
Certificate Expiration DateOctober 8, 2027
Laboratory DirectorDr. Eric Hanson
Laboratory Phone(503) 253-3910
Laboratory LocationKnott Street Dermatology10024 SE 32nd Ave, Milwaukie, OR 97222
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 5

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

MICHAEL ANTHONY ST AMAND PAC
Physician Assistant (Surgical)
301 NE KNOTT ST
PORTLAND, OR 97212
Multnomah County (503) 253-3910
KATIE CONKLIN ARNP
Nurse Practitioner (Family)
301 NE KNOTT ST
PORTLAND, OR 97212
Multnomah County (503) 253-3910
DR. KAREN ELLEN MINZER-CONZETTI M.D.
Dermatology
301 NE KNOTT ST
PORTLAND, OR 97212
Multnomah County (503) 253-3910
CRAIG SCHULTZ
Nurse Practitioner
301 NE KNOTT ST
PORTLAND, OR 97212
Multnomah County (503) 253-3910
DR. ERIC L HANSON MD
Dermatology (Procedural Dermatology)
301 NE KNOTT ST
PORTLAND, OR 97212
Multnomah County (503) 253-3910

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 Knott Street Dermatology PC's NPI number?

The NPI number for Knott Street Dermatology PC is 1891741864. It was assigned to this organization in the NPPES registry on May 25, 2006.

Where is Knott Street Dermatology PC located?

Knott Street Dermatology PC is located at 301 NE Knott St, Portland, OR 97212. The listed phone number is (503) 253-2675.

What is Knott Street Dermatology PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Knott Street Dermatology PC hold CLIA laboratory certificates?

Yes. 2 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 Knott Street Dermatology PC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Knott Street 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 Knott Street Dermatology PC was last updated on August 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.