| Deniese Elaine Jensen Granville, DPM | |
|
55 S State St Ste 3220, Lake Oswego, OR 97034-3975 | |
| (503) 635-7742 | |
| (503) 635-8495 |
| Full Name | Deniese Elaine Jensen Granville |
|---|---|
| Gender | Female |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 55 S State St Ste 3220, Lake Oswego, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134291438 | NPI | - | NPPES |
| 038377 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | DP00223 (Oregon) | Primary |
| Provider Name | Kaiser Foundation Health Plan Of The Northwest |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040130000799 |
| Mailing Address | Practice Location Address |
|---|---|
| Deniese Elaine Jensen Granville, DPM 55 S State St Ste 3220, Lake Oswego, OR 97034-3975 Ph: (503) 635-7742 | Deniese Elaine Jensen Granville, DPM 55 S State St Ste 3220, Lake Oswego, OR 97034-3975 Ph: (503) 635-7742 |
Dr. Mark Thomas Hastings, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 16316 Bryant Rd, Lake Oswego, OR 97035 Phone: 503-699-8220 Fax: 503-699-7949 | |
Oregon Institute Of Foot Care Llc Podiatrist Medicare: Medicare Enrolled Practice Location: 55 S State St Ste 3220, Lake Oswego, OR 97034 Phone: 503-635-7742 | |
Jon Todd Fitzgerald, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 543 3rd St, Ste C1, Lake Oswego, OR 97034 Phone: 503-636-9656 Fax: 503-636-9657 | |
Dr. Viengkeo T Noimany, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 18231 Siena Dr, Lake Oswego, OR 97034 Phone: 503-702-3803 | |
Myles Knutson, Dpm, Llc Podiatrist Medicare: Medicare Enrolled Practice Location: 311 B Ave Ste B, Lake Oswego, OR 97034 Phone: 503-804-7579 Fax: 503-210-0364 | |
Jerry J Yoon, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 4000 Kruse Way Pl Ste 220, Bldg 2, Lake Oswego, OR 97035 Phone: 503-636-9656 Fax: 503-636-9657 |