=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750490553
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CYAANDI RHONE DOVE D.P.M.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2006
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9605 GRAND RONDE RD
-----------------------------------------------------
City | GRAND RONDE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97347-9712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-879-2002
-----------------------------------------------------
Fax | 503-879-2071
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9605 GRAND RONDE RD
-----------------------------------------------------
City | GRAND RONDE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97347-9712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-879-2002
-----------------------------------------------------
Fax | 503-879-2071
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | N005845
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213EP1101X
-----------------------------------------------------
Taxonomy Name | Primary Podiatric Medicine Podiatrist
-----------------------------------------------------
License Number | 0602
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | DP223397
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------