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Individual

DR. WAYNE A VETTER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
5528 SE POWELL BLVD, PORTLAND, OR 97206-2956
(503) 777-3999
(503) 777-2914
Mailing address
5528 SE POWELL BLVD, PORTLAND, OR 97206-2956
(503) 777-3999
(503) 777-2914

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0506
AZ
213E00000X
Podiatrist
Primary
DP00133
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
170134
OR
05
236182
OR
Enumeration date
08/25/2005
Last updated
07/08/2007
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