| |
965 N Cascade Dr, Woodburn, OR 97071-3140 | |
(503) 982-1112 | |
(503) 981-0732 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 965 N Cascade Dr, Woodburn, Oregon |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710160668 | NPI | - | NPPES |
080747 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | DP00614 (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
965 N Cascade Dr, Po Box 221, Woodburn, OR 97071-3140 Ph: (503) 982-1112 | 965 N Cascade Dr, Woodburn, OR 97071-3140 Ph: (503) 982-1112 |