Healthcare Provider Details

I. General information

NPI: 1497232474
Provider Name (Legal Business Name): ADVANCED FOOT & ANKLE SPECIALISTS OF OREGON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 VALLEY RIVER DR STE 210
EUGENE OR
97401-6759
US

IV. Provider business mailing address

1400 VALLEY RIVER DR STE 210
EUGENE OR
97401-6759
US

V. Phone/Fax

Practice location:
  • Phone: 541-600-4630
  • Fax: 877-370-7523
Mailing address:
  • Phone: 541-600-4630
  • Fax: 877-370-7523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. DREW PEARSON
Title or Position: OWNER
Credential: DPM
Phone: 541-729-1031