Individual
JAMIE MIERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
25050 SE STARK ST, STE 265, GRESHAM, OR 97030-3327
(503) 413-2005
(503) 413-3699
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP181086
OR
213ES0103X
Foot & Ankle Surgery Podiatrist
E 5094
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
POD.0000736
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
329089YXFB
MEDICARE
CO
Enumeration date
04/13/2010
Last updated
01/10/2017
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