| |
1369 N 10th Ave, Stayton, OR 97383-2037 | |
(503) 769-7960 | |
(503) 769-9860 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 1369 N 10th Ave, Stayton, Oregon |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417126434 | NPI | - | NPPES |
271049 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | DP00368 (Oregon) | Primary |
Mailing Address | Practice Location Address |
---|---|
1369 N 10th Ave, Stayton, OR 97383-2037 Ph: (503) 769-7960 | 1369 N 10th Ave, Stayton, OR 97383-2037 Ph: (503) 769-7960 |
Dr. Ruben Pollak, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1369 N 10th Ave, Stayton, OR 97383 Phone: 503-769-7960 Fax: 503-769-9860 |