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ADVANCED FOOT CLINIC PC NPI 1063518132


NPI Information

NPI: 1063518132
Provider Name: ADVANCED FOOT CLINIC, PC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
6464 SW BORLAND RD STE B3
TUALATIN, OR
ZIP 97062
Phone: (503) 612-4040
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ADVANCED FOOT CLINIC, PC is a podiatrist in Tualatin, 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. ADVANCED FOOT CLINIC, PC NPI is 1063518132. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6464 SW BORLAND RD STE B3
TUALATIN, OR
ZIP 97062-855
Phone: (503) 612-4040
Fax: (503) 625-8638

The provider's authorized official is Azadeh Arabshahi .
The authorized official title is Administrator/manager and has the following contact phone number (503) 391-0688.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 3/9/2023.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristDP00296OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1R116947OTHEROREGONMEDICARE
25738490002OTHEROREGONMEDICARE DME
3480034478OTHEROREGONRAILROAD MEDICARE
4158911MEDICAIDOREGON
5480034478OTHEROREGONPALMETTO GBA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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