WILLAMETTE MEDICAL LABS INC. NPI 1891025854

NPI Information

  • NPI: 1891025854
  • Provider Name: WILLAMETTE MEDICAL LABS, INC.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Doing Business As: AESTHETIC MEDICINE
  • CLIA Number: 38D0978577
  • Address: 9735 SW SHADY LN STE 203
    TIGARD, OR
    ZIP 97223
  • Phone: (503) 697-9777

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NPI Details

WILLAMETTE MEDICAL LABS, INC. is a specialist in Tigard, OR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. WILLAMETTE MEDICAL LABS, INC. NPI is 1891025854. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Aesthetic Medicine.

The provider's business location address is:

9735 SW SHADY LN STE 203
TIGARD, OR
ZIP 97223-481
Phone: (503) 697-9777
Fax: (503) 597-3708

The provider's authorized official is Jerry Darm .
The authorized official title is President and has the following contact phone number (503) 697-9777.

The CLIA number assigned to this NPI record is 38D0978577 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/13/2010 and was last updated on 1/13/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistMD10790OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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