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Individual

DR. MATTHEW MASON BOOKWALTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
800 SW 13TH AVE, PORTLAND, OR 97205
(503) 221-0161
(503) 221-4451
Mailing address
PO BOX PH, CHINLE, AZ 86503-8000
(928) 674-7166
(928) 674-7705

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP 00347
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
229013
OR
Enumeration date
11/13/2006
Last updated
03/03/2011
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