Organization
DEAN MCNABB DPM LLC
Active
Other names
PACIFIC NW FOOT AND ANKLE
Organization subpart
No
Provider details
NPI number
Authorized official
EARL DEAN MCNABB DPM (OWNER)
(503) 390-0959
Entity
Organization
Contact information
Practice address
3625 RIVER RD N STE 275, KEIZER, OR 97303-5985
(503) 390-0959
(877) 878-1984
Mailing address
PO BOX 20367, KEIZER, OR 97307-0367
(503) 390-0959
(877) 878-1984
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182958
—
OR
01
—
R133627
MEDICARE KEIZER
OR
Enumeration date
10/10/2007
Last updated
06/17/2013
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