Organization
CLACKAMAS FOOT & ANKLE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THUY-TRANG LAM DPM (PRESIDENT, DPM)
(503) 652-9671
Entity
Organization
Contact information
Practice address
8800 SE SUNNYSIDE RD, SUITE 105N, CLACKAMAS, OR 97015-5738
(503) 652-9671
Mailing address
8800 SE SUNNYSIDE RD, SUITE 105N, CLACKAMAS, OR 97015-5738
(503) 652-9671
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
DP00267
OR
213ES0131X
Foot Surgery Podiatrist
Primary
DP00267
OR
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480019925
MEDICARE RAILROAD GBA
OR
01
—
DE4383
MEDICARE RAILROAD - GBA
OR
Enumeration date
11/28/2006
Last updated
01/15/2009
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