Clackamas Dermatology PC
NPI 1700221397ActiveOrganization· Dermatology· Clackamas, OR
Dermatology in Clackamas, Oregon, registered in NPPES in May 2013. The authorized official on file is Paul Jeffery Anderud, D.O., Owner/Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1700221397 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 8, 2013 |
| Last updated in NPPES | May 25, 2023 |
| Certified by provider | May 25, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | DO157838 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OR) |
|---|
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