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Organization
DEAN MCNABB DPM LLC
Active
Organization
DEAN MCNABB DPM LLC
Active
Other names
PACIFIC NW FOOT AND ANKLE
Organization subpart
No
Provider details
NPI number
Authorized official
EARL DEAN MCNABB DPM (OWNER)
(503) 390-0959
Entity
Organization
Contact information
Practice address
3625 RIVER RD N STE 275, KEIZER, OR 97303-5985
(503) 390-0959
(877) 878-1984
Mailing address
PO BOX 20367, KEIZER, OR 97307-0367
(503) 390-0959
(877) 878-1984
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182958
—
OR
01
—
R133627
MEDICARE KEIZER
OR
Enumeration date
10/10/2007
Last updated
06/17/2013
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