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Organization

OREGON INSTITUTE OF FOOT CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TYLER MANSON DPM (PODIATRIC PHYSICIAN)
(503) 635-7742
Entity
Organization

Contact information

Practice address
55 S STATE ST STE 3220, LAKE OSWEGO, OR 97034-3975
(503) 635-7742
Mailing address
55 S STATE ST STE 3220, LAKE OSWEGO, OR 97034-3975
(503) 635-7742

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
213EP1101X
Primary Podiatric Medicine Podiatrist
213ER0200X
Radiology Podiatrist
213ES0000X
Sports Medicine Podiatrist
213ES0131X
Foot Surgery Podiatrist

Other

Enumeration date
11/02/2021
Last updated
03/24/2022
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