Provider Demographics
NPI:1497232474
Name:ADVANCED FOOT & ANKLE SPECIALISTS OF OREGON LLC
Entity Type:Organization
Organization Name:ADVANCED FOOT & ANKLE SPECIALISTS OF OREGON LLC
Other - Org Name:CASCADIA FOOT & ANKLE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:541-729-1031
Mailing Address - Street 1:1400 VALLEY RIVER DR STE 210
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6759
Mailing Address - Country:US
Mailing Address - Phone:541-600-4630
Mailing Address - Fax:877-370-7523
Practice Address - Street 1:1400 VALLEY RIVER DR STE 210
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6759
Practice Address - Country:US
Practice Address - Phone:541-600-4630
Practice Address - Fax:877-370-7523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty