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Individual

ZACKERY DAVID NANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
5050 NE HOYT ST STE 223, PORTLAND, OR 97213-2980
(503) 963-2964
(503) 963-2966
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP167551
OR
213ES0103X
Foot & Ankle Surgery Podiatrist
SC006300
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1194012989
WA
05
500670855
OR
Enumeration date
06/30/2011
Last updated
11/24/2025
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