Organization
YAMA A DEHQANZADA DPM PC
Active
Organization
YAMA A DEHQANZADA DPM PC
Active
Other names
Sherwood Foot and Ankle Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YAMA AHMAD DEHQANZADA DPM (CEO/PRESIDENT)
(503) 925-8120
Entity
Organization
Contact information
Practice address
16770 SW EDY RD, SUITE 216, SHERWOOD, OR 97140-9678
(503) 925-8120
(503) 925-8121
Mailing address
16770 SW EDY RD, SUITE 216, SHERWOOD, OR 97140-9678
(503) 925-8120
(503) 925-8121
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
DP00348
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154338275
INDIVIDUAL NPI
OR
Enumeration date
09/06/2007
Last updated
09/06/2007
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