Individual
EDWARD THEODORE YSUNZA IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
21540 NW FRANSON WAY # 2201, HILLSBORO, OR 97006-6076
(503) 858-4641
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP170018
OR
Other
Enumeration date
04/11/2011
Last updated
03/10/2016
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