Provider Demographics
NPI:1376088963
Name:ANKLE AND FOOT PHYSICIANS AND SURGEONS LLC
Entity Type:Organization
Organization Name:ANKLE AND FOOT PHYSICIANS AND SURGEONS LLC
Other - Org Name:ANKLE AND FOOT PHYSICIANS AND SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WENZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:541-716-5185
Mailing Address - Street 1:601 SE 117TH AVE
Mailing Address - Street 2:STE 240
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5297
Mailing Address - Country:US
Mailing Address - Phone:360-977-7815
Mailing Address - Fax:
Practice Address - Street 1:1700 12TH ST
Practice Address - Street 2:STE E
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9540
Practice Address - Country:US
Practice Address - Phone:541-716-5185
Practice Address - Fax:888-625-8659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty