Provider Demographics
NPI:1710160668
Name:BRIAN G ORAHOOD
Entity Type:Organization
Organization Name:BRIAN G ORAHOOD
Other - Org Name:OREGON FOOT AND ANKLE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ORAHOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:503-982-1112
Mailing Address - Street 1:965 N CASCADE DR
Mailing Address - Street 2:PO BOX 221
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071-3140
Mailing Address - Country:US
Mailing Address - Phone:503-982-1112
Mailing Address - Fax:503-981-0732
Practice Address - Street 1:965 N CASCADE DR
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-3140
Practice Address - Country:US
Practice Address - Phone:503-982-1112
Practice Address - Fax:503-981-0732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DP00614213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR080747Medicaid
ORR00WCQHRAMedicare PIN
ORR0000WCQHRMedicare PIN
OR0427310002Medicare NSC