Provider Demographics
NPI:1275912578
Name:OREGON PEDORTHIC SERVICES INC
Entity Type:Organization
Organization Name:OREGON PEDORTHIC SERVICES INC
Other - Org Name:ARCH FITTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCURTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:503-491-1723
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-0154
Mailing Address - Country:US
Mailing Address - Phone:503-491-1723
Mailing Address - Fax:503-489-0706
Practice Address - Street 1:8301 SE 13TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-7101
Practice Address - Country:US
Practice Address - Phone:971-254-8142
Practice Address - Fax:503-489-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment