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Organization
ORTHOPEDIC SPECIALISTS, PC
Active
Organization
ORTHOPEDIC SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE BISSETT (CREDENTIALING)
(503) 467-7060
Entity
Organization
Contact information
Practice address
5050 NE HOYT ST STE 340, PORTLAND, OR 97213-2983
(503) 467-7082
(503) 467-7099
Mailing address
5050 NE HOYT ST STE 340, PORTLAND, OR 97213-2983
(503) 467-7082
(503) 467-7099
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD13922
OR
332B00000X
Durable Medical Equipment & Medical Supplies
MD13922
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141937
—
OR
01
—
R0000WCGGC
PTAN
OR
Enumeration date
08/23/2011
Last updated
06/26/2017
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