Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Oswego Dermatology Group, PC

Organization Dermatology Physician · NPI 1710167689

Lake Oswego Dermatology Group, PC provides Dermatology Physician services in Lake Oswego, Oregon. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

17704 Jean Way Ste 102
Lake Oswego, OR 97035-5497 Not confirmed with CMS for 16 years — call before visiting
Phone: (503) 635-9221
Fax: (503) 635-5902
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1710167689
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rita Shigeta — Office Manager · (503) 635-9221
NPI enumeratedNovember 8, 2007
Last updated in NPPESFebruary 3, 2010
Mailing address17704 Jean Way, Suite 102, Lake Oswego, OR 97035-5497

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