Individual
CHARLES SAMUEL GOLDFOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1650 NW 13TH AVE APT 109, PORTLAND, OR 97209-3694
(971) 340-6523
Mailing address
1650 NW 13TH AVE APT 109, PORTLAND, OR 97209-3694
(971) 340-6523
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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