| Gresham Podiatry Center, Llc | |
|
831 Nw Council Dr, Suite #203, Gresham, OR 97030-3721 | |
| (503) 667-6600 | |
| (503) 667-6608 |
| Full Name | Gresham Podiatry Center, Llc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 831 Nw Council Dr, Gresham, Oregon |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891742318 | NPI | - | NPPES |
| 1891742318 | Other | OR | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 307 (Oregon) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Gresham Podiatry Center, Llc 831 Nw Council Dr, Suite #203, Gresham, OR 97030-3721 Ph: (503) 667-6600 | Gresham Podiatry Center, Llc 831 Nw Council Dr, Suite #203, Gresham, OR 97030-3721 Ph: (503) 667-6600 |
Dr. Timothy James Mineo, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 24076 Se Stark St, Suite 110, Gresham, OR 97030 Phone: 503-661-5388 | |
Dr. Marshal Terrance Kennedy, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2775 Se Powell Valley Rd, Gresham, OR 97080 Phone: 503-667-7789 Fax: 503-667-2032 | |
Dr. Derek J Mccammon, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 24076 Se Stark St Ste 110, Gresham, OR 97030 Phone: 503-661-5388 Fax: 503-666-9393 | |
Dr. Grayden Woodruff King, D.P.M Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 831 Nw Council Dr, Ste 203, Gresham, OR 97030 Phone: 503-667-6600 Fax: 503-667-6608 | |
Jamie Mieras, D.P.M. Podiatrist Medicare: Medicare Enrolled Practice Location: 25050 Se Stark St, Ste 265, Gresham, OR 97030 Phone: 503-413-2005 Fax: 503-413-3699 |