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Organization

EASTSIDE FOOT AND ANKLE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN BOWEN DPM (PODIATRIST/OWNER)
(503) 284-2000
Entity
Organization

Contact information

Practice address
1827 NE 44TH AVE STE 100, PORTLAND, OR 97213-1443
(503) 284-2000
(503) 284-2002
Mailing address
1827 NE 44TH AVE STE 100, PORTLAND, OR 97213-1443
(503) 284-2000
(503) 284-2002

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP00435
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500607151
OR
Enumeration date
05/20/2014
Last updated
12/13/2021
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