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

Epiphany Dermatology of Oregon, LLC

Organization Dermatology Physician · NPI 1174697239

Epiphany Dermatology of Oregon, LLC is a Dermatology Physician in Portland, Oregon. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2222 NW Lovejoy St Ste 422
Portland, OR 97210-3033
Phone: (503) 227-7117
Fax: (503) 227-7120
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 number1174697239
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gheorghe Pusta — Secretary · (512) 628-0465
NPI enumeratedNovember 20, 2006
Last updated in NPPESJuly 21, 2025
Certification dateJuly 21, 2025
Mailing address7300 Ranch Road 2222, Bldg 1, Ste 200, Austin, TX 78730-3255

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