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NPI Code Detail

MEDICARE: OCCUPATIONAL ORTHOPEDICS LLC

MEDICARE: OCCUPATIONAL ORTHOPEDICS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianMD13624OR

General Provider Information

NPI Number : 1811265291
Entity Type Code : Organization
Provider Name (Legal Business Name) : OCCUPATIONAL ORTHOPEDICS LLC
Provider Business Mailing Address
First Line : 6464 SW BORLAND RD STE C4
Second Line :
City : TUALATIN
State : OR
Zip : 97062-8856
Country : US
Telephone Number : 503-885-7770
Fax Number : 503-961-8454
Provider Business Practice Location Address
First Line : 6464 SW BORLAND RD STE C4
Second Line :
City : TUALATIN
State : OR
Zip : 97062-8856
Country : US
Telephone Number : 503-885-7770
Fax Number : 503-961-8454
Authorized Official
Title or Position : OFFICE MANAGER
Name : MS. DAWN JENNINGS
Credential :
Telephone Number : 503-885-7770
Provider Enumeration Date : 12/13/2011
Last Update Date : 12/13/2011

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Directions to “OCCUPATIONAL ORTHOPEDICS LLC ” Practice Location

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