Organization
BRIDGE CITY FOOT & ANKLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER STACH DPM (OWNER/PODIATRIC PHYSICIAN)
(503) 805-4720
Entity
Organization
Contact information
Practice address
4770 SW WATSON AVE, BEAVERTON, OR 97005-0511
(503) 427-8967
(971) 223-0096
Mailing address
1720 SW HUNTINGTON AVE, PORTLAND, OR 97225-4752
(503) 805-4720
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
11/09/2020
Last updated
10/18/2023
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