OrganizationActive
Grace Dermatology & Micrographic Surgery LLC
NPI 1184973828 · Medical Specialty Clinic/Center · Lebanon, OR
Provider details
- NPI number
- 1184973828
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kyle Horner, Owner(206) 465-8046
- License
- MD153145 (OR)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2500 S Main Rd
Lebanon, OR 97355-2336
Phone: (206) 465-8046
Street-level locationGet directions
Mailing address
2500 S Main Rd
Lebanon, OR 97355-2336
Registry dates
- Enumerated
- 2012-09-07
- Last updated
- 2012-11-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.