Organization
LAKE OSWEGO FOOT CLINIC
Active
Organization
LAKE OSWEGO FOOT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY J YOON DPM (PODIATRIST)
(503) 777-3999
Entity
Organization
Contact information
Practice address
4000 KRUSE WAY PLACE, BLDG 2, STE 220, LAKE OSWEGO, OR 97035
(503) 636-9656
(503) 636-9657
Mailing address
4000 KRUSE WAY PLACE, BLDG 2, STE 220, LAKE OSWEGO, OR 97035
(503) 636-9656
(503) 636-9657
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
DP00338
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286958
—
OR
Enumeration date
07/31/2008
Last updated
02/18/2025
Update your record
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