OrganizationActive
Northwest Dermatology & Laser Clinic PC
NPI 1376571364 · Dermatology Physician · Portland, OR
Provider details
- NPI number
- 1376571364
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Bert Tavelli, President(503) 295-2366
- License
- MD14681 (OR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
1130 Nw 22nd Ave Ste 330
Portland, OR 97210-2970
Phone: (503) 295-2366
Fax: (503) 295-3065
Street-level locationGet directions
Mailing address
Po Box 23200
Portland, OR 97281-3200
Registry dates
- Enumerated
- 2006-06-29
- Last updated
- 2016-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.