Organization
ADVANCED FOOT CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZADEH ARABSHAHI (ADMINISTRATOR/MANAGER)
(503) 391-0688
Entity
Organization
Contact information
Practice address
6464 SW BORLAND RD STE B3, TUALATIN, OR 97062-8855
(503) 612-4040
(503) 625-8638
Mailing address
PO BOX 1550, SHERWOOD, OR 97140-1550
(503) 612-4040
(503) 625-8638
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00296
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158911
—
OR
01
—
480034478
RAILROAD MEDICARE
OR
01
—
5738490002
MEDICARE DME
OR
01
—
R116947
MEDICARE
OR
Enumeration date
09/16/2006
Last updated
03/09/2023
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