Healthcare Provider Details

I. General information

NPI: 1427200021
Provider Name (Legal Business Name): SUMMIT ORTHOPAEDICS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 MERCANTILE DR STE B
LAKE OSWEGO OR
97035-2557
US

IV. Provider business mailing address

PO BOX 42928
BELFAST ME
04915-1281
US

V. Phone/Fax

Practice location:
  • Phone: 503-850-9940
  • Fax: 503-850-6709
Mailing address:
  • Phone: 503-850-9940
  • Fax: 503-850-6709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ANGELA TOEDTEMEIER
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 503-850-9940