| NPI | 1457498438 |
|---|---|
| Former Legal Business Name | BROADWAY FOOT CLINIC |
| Entity Type | Organization |
| Authorized Contact | ELLIOT MICHAEL Dpm 503-648-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR dp00179) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR dp00315) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR dp00244) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2009-08-07 |