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Organization
COLUMBIA FOOT AND ANKLE CLINIC, LLC
Active
Organization
COLUMBIA FOOT AND ANKLE CLINIC, LLC
Active
Other names
Columbia Foot and Ankle Clinic, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JANE H COX ADMINISTRATOR (CREDENTIALING SPECIALIST)
(949) 664-2796
Entity
Organization
Contact information
Practice address
12411 NE 70TH CIR, VANCOUVER, WA 98682-4885
(602) 615-9915
Mailing address
12411 NE 70TH CIR, VANCOUVER, WA 98682-4885
(602) 615-9915
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265164198
NPI
WA
05
—
2228399
—
WA
05
—
500823690
—
OR
Enumeration date
10/04/2023
Last updated
03/13/2024
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