Clackamas Dermatology PC
NPI 1700221397 · Dermatology Physician · Clackamas, OR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Clackamas Dermatology PC is a Dermatology Physician organization in Clackamas, OR (NPI 1700221397).
Provider details
- NPI number
- 1700221397
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Paul Anderud, Owner/Ceo(503) 654-7546
- License
- DO157838 (OR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
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
Mailing address
Other names (DBA / former)
- Doing business as
- Goodskin Dermatology
- Doing business as
- Goodskin Dermatology
Registry dates
- Enumerated
- 2013-05-08
- Last updated
- 2023-05-25
- Certified
- 2023-05-25
Frequently asked questions
- What is Clackamas Dermatology PC's NPI number?
- Clackamas Dermatology PC's National Provider Identifier (NPI) is 1700221397, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Clackamas Dermatology PC?
- Clackamas Dermatology PC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Clackamas Dermatology PC located?
- Clackamas Dermatology PC's practice location on file with NPPES is 12605 Se 97th Ave, Clackamas, OR 97015-9706.
- What is Clackamas Dermatology PC's phone number?
- The practice phone number listed in the NPPES registry for Clackamas Dermatology PC is (503) 654-7546.
- Does Clackamas Dermatology PC accept Medicare?
- Clackamas Dermatology PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Clackamas Dermatology PC?
- The authorized official listed on Clackamas Dermatology PC's NPPES record is Paul Anderud, Owner/Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Clackamas Dermatology PC's NPI active?
- Yes — Clackamas Dermatology PC's NPI (1700221397) is active in the NPPES registry as of the last update on 2023-05-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.