Provider Demographics
NPI:1750490553
Name:DOVE, CYAANDI RHONE (DPM)
Entity type:Individual
Prefix:DR
First Name:CYAANDI
Middle Name:RHONE
Last Name:DOVE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9605 GRAND RONDE RD
Mailing Address - Street 2:
Mailing Address - City:GRAND RONDE
Mailing Address - State:OR
Mailing Address - Zip Code:97347-9712
Mailing Address - Country:US
Mailing Address - Phone:503-879-2002
Mailing Address - Fax:503-879-2071
Practice Address - Street 1:9605 GRAND RONDE RD
Practice Address - Street 2:
Practice Address - City:GRAND RONDE
Practice Address - State:OR
Practice Address - Zip Code:97347-9712
Practice Address - Country:US
Practice Address - Phone:503-879-2002
Practice Address - Fax:503-879-2071
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005845213E00000X
NV0602213EP1101X
ORDP223397213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN005845OtherN.Y PODIATR. MED. LICENS
NVP00615727OtherRAILROAD MEDICARE PART B
NV0602OtherNEVADA LICENSE
NV5849640001OtherDME
NV103480Medicare PIN
NYU87640Medicare UPIN