Westside Podiatry Clinic LLC

NPI #1427164516 in Tigard, Oregon

Provider Information

NPI Number: 1427164516
Entity Type: Organization
Organization Name: Westside Podiatry Clinic LLC
Primary Specialty: Podiatrist
Enumeration Date: Aug 22, 2006
Last Updated: Jul 21, 2010

Practice Location

Address: 9900 SW HALL BLVD
Address 2: SUIT 100
City: Tigard
State: Oregon
ZIP Code: 97223
Phone: (503) 245-2420

Authorized Official

Name: DR. JASON R SURRATT, DPM
Title: OWNER
Phone: (503) 245-2420

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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