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

Dr. Stephen John Mannino, MD

Individual provider Dermatology Physician · NPI 1679553218

Dr. Stephen John Mannino, MD is a Dermatology in Tigard, Oregon. Graduated from Louisiana State University School of Medicine in New Orleans in 2003, 23 years ago. Practices with Mountain West Derm - Blackhart PLLC, a 103-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
23
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
OR
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

10215 SW Hall Blvd
Tigard, OR 97223-8809
Phone: (503) 245-2415
Fax: (503) 244-5963
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4004 Kruse Way Pl Ste 220, Lake Oswego, OR 97035-2449 — (503) 245-2415

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence MD157027 (OR)

Record details

NPI number1679553218
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 19, 2006
Last updated in NPPESJune 27, 2025
Certification dateJune 27, 2025
Mailing address10215 Sw Hall Blvd, Tigard, OR 97223-8809

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2003 (23 years in practice)
Group practice Mountain West Derm - Blackhart Pllc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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