WESTSIDE PODIATRY CLINIC LLC NPI 1427164516

NPI Information

WESTSIDE PODIATRY CLINIC LLC is a podiatrist in Tigard, OR. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. WESTSIDE PODIATRY CLINIC LLC NPI is 1427164516. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9900 SW HALL BLVD
SUIT 100
TIGARD, OR
ZIP 97223
Phone: (503) 245-2420
Fax: (503) 245-2445

The provider's authorized official is Jason R Surratt .
The authorized official title is Owner and has the following contact phone number (503) 245-2420.

The enumeration date for this NPI number is 8/22/2006 and was last updated on 7/21/2010.

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:

Other Identifiers

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