Individual
MR. ERIC LEE FOOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
18610 NW CORNELL RD, STE 101, HILLSBORO, OR 97124-9206
(503) 216-9360
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01392
OR
363AM0700X
Medical Physician Assistant
PA01392
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500629100
—
OR
Enumeration date
10/02/2008
Last updated
10/19/2021
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