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Organization
WESTSIDE PODIATRY CLINIC LLC
Active
Organization
WESTSIDE PODIATRY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON R SURRATT DPM (OWNER)
(503) 245-2420
Entity
Organization
Contact information
Practice address
9900 SW HALL BLVD, SUIT 100, TIGARD, OR 97223
(503) 245-2420
(503) 245-2445
Mailing address
9900 SW HALL BLVD, SUIT 100, TIGARD, OR 97223
(503) 245-2420
(503) 245-2445
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
08/22/2006
Last updated
07/21/2010
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