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Organization
SOUTHWEST FOOT AND ANKLE CENTER LLC
Active
Organization
SOUTHWEST FOOT AND ANKLE CENTER LLC
Active
Other names
Southwest Foot & Ankle
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETRINA C LEWIS DPM (OWNER)
(425) 277-3668
Entity
Organization
Contact information
Practice address
9343 E SHEA BLVD STE B-130, SCOTTSDALE, AZ 85260-6802
(425) 277-3668
(425) 277-0732
Mailing address
4300 TALBOT RD S STE 102, RENTON, WA 98055-6238
(425) 277-3668
(425) 277-0732
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
213ES0000X
Sports Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8146570001
NORIDIAN
AZ
Enumeration date
07/19/2021
Last updated
01/05/2023
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