Provider Demographics
NPI:1568151561
Name:REGENERATIVE ORTHOPEDIC CENTER LLC
Entity Type:Organization
Organization Name:REGENERATIVE ORTHOPEDIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:FEINBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-905-4103
Mailing Address - Street 1:7401 SW WASHO CT STE 100
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8342
Mailing Address - Country:US
Mailing Address - Phone:503-905-4103
Mailing Address - Fax:503-656-9464
Practice Address - Street 1:7401 SW WASHO CT STE 100
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8342
Practice Address - Country:US
Practice Address - Phone:503-905-4103
Practice Address - Fax:503-656-9464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty