Organization
NORTHWEST FOOT & ANKLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY A MCCLANAHAN DPM (OWNER)
(503) 243-2699
Entity
Organization
Contact information
Practice address
725 NW 19TH AVE, PORTLAND, OR 97209-1301
(503) 243-2699
(503) 243-2698
Mailing address
725 NW 19TH AVE, PORTLAND, OR 97209-1301
(503) 243-2699
(503) 243-2698
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00317
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1101682
—
OR
01
—
208339
DSHS (MEDICAID)
OR
01
—
480027978
RAILROAD MEDICARE
OR
01
—
MC5942
REGENCE RIDER
OR
Enumeration date
11/24/2006
Last updated
03/07/2023
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