Individual
CHARLES JUSTIN PETIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17355 LOWER BOONES FERRY RD, #100A, LAKE OSWEGO, OR 97035-2839
(503) 224-8399
(503) 224-5661
Mailing address
17355 LOWER BOONES FERRY RD, #100A, LAKE OSWEGO, OR 97035-2839
(503) 224-8399
(503) 224-5661
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD29397
OR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD29397
OR
Other
Enumeration date
11/03/2005
Last updated
08/25/2025
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