Healthcare Provider Details

I. General information

NPI: 1851400493
Provider Name (Legal Business Name): RICHARD STEVEN KRAHNKE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 N INTERSTATE AVE
PORTLAND OR
97227-1196
US

IV. Provider business mailing address

2875 NW STUCKI AVE
HILLSBORO OR
97124-5806
US

V. Phone/Fax

Practice location:
  • Phone: 503-285-9321
  • Fax:
Mailing address:
  • Phone: 971-310-3237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO00000738
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDP00342
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: