GRACE DERMATOLOGY & MICROGRAPHIC SURGERY LLC (NPI# 1184973828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184973828 |
| Entity Type | Organization |
| Organization Name | GRACE DERMATOLOGY & MICROGRAPHIC SURGERY LLC |
| Practice Address |
2500 S Main Rd Lebanon OR 97355-2336 |
| Practice Telephone | 2064658046 |
| Mailing Telephone | 2064658046 |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-11-26 |
| Authorized Official Name | KYLE LELAND HORNER (OWNER) |
| Authorized Official Telephone | 2064658046 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
MD153145 | OR | Ambulatory Health Care Facilities |
| Street Address |
2500 S MAIN RD |
| City | LEBANON |
| State | OR |
| Zip Code | 97355-2336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710516182 | Patricia Hoangphuong Nguyen | Student in an Organized Health Care Education/Training Program | Western University of Health Sciences Comp-northwest, 200 Mullins Drive, Lebanon, OR 97355 | 2020-04-07 |
| 1528609740 | Liana Beaty | Technician | 31231 Mccraven Ln, Lebanon, OR 97355 | 2019-09-30 |
| 1710465323 | Jackie Welter | Health Educator | 35 Mullins Drvie Ste 3, Lebanon, OR 97355 | 2018-08-06 |
| 1518415371 | Kathleen Hillary | Registered Nurse | 525 North Santiam Highway, Lebanon, OR 97355 | 2016-09-21 |
| 1861849283 | Emily Marshall | Student in an Organized Health Care Education/Training Program | 200 Mullins Drive, Lebanon, OR 97355 | 2016-05-16 |
| 1033565551 | Celeste Maxine Croy-baker | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr., Lebanon, OR 97355 | 2016-05-13 |
| 1770956963 | Jeff Parsons | Occupational Therapist | 600 Ne 5th St, Oregon Veterans Home, Lebanon, OR 97355 | 2015-11-10 |
| 1003289588 | Hong Ngoc Nguyen | Pharmacist | 675 N Fifth Street, Lebanon, OR 97355 | 2015-11-05 |
| 1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
| 1679985113 | State of Oregon Department of Veterans' Affairs | Skilled Nursing Facility | 600 N. 5th Street, Lebanon, OR 97355 | 2014-06-02 |
| Find all providers in zip 97355 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1235170010 | Regional Ent Associates, P.C. | Clinic/Center | 206a Babb Dr, Lebanon, TN 37087-2508 | 2006-06-10 |
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| 1932566320 | Dr Steven Clark and Associates, LLC | Clinic/Center | 697 Nw Division St, Gresham, OR 97030-5424 | 2016-01-15 |
| 1174907638 | Bridgeton Chiropractic, LLC | Clinic/Center | 10350 N Vancouver Way # 92, Portland, OR 97217-7530 | 2015-07-15 |
| 1356745301 | Deschutes Health LLC | Clinic/Center | 612 Ne Savannah Dr, Suite 1, Bend, OR 97701-4874 | 2014-10-20 |
| 1447677059 | Ent Facial Plastic and Laser Center, Inc | Clinic/Center | 600 Nw 11th St Ste E21, Hermiston, OR 97838-8603 | 2014-03-20 |
| 1154661163 | Sundara Acupuncture LLC | Clinic/Center | 17175 Sw Lisa St, Beaverton, OR 97006-4185 | 2013-02-28 |
| 1053659938 | Dedicated Sleep, LLC | Clinic/Center | 21260 S Springwater Rd, Estacada, OR 97023-9650 | 2013-01-28 |
| 1912241746 | Portland Preventive Cardiology LLC | Clinic/Center | 8855 Sw Canyon Ln, Portland, OR 97225-3411 | 2012-11-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.