Individual
DR. KEVIN DENNIS DRISCOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6108 NE GLISAN ST, PORTLAND, OR 97213-3864
(503) 255-8100
(503) 255-2728
Mailing address
6108 NE GLISAN ST, PORTLAND, OR 97213-3864
(503) 255-8100
(503) 255-2728
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
000000
PA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
DP202065
OR
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
SC006916
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
DP202065
OR
213ES0103X
Foot & Ankle Surgery Podiatrist
SC006916
PA
213ES0131X
Foot Surgery Podiatrist
DP202065
OR
Other
Enumeration date
04/05/2018
Last updated
09/30/2021
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