Provider Demographics
NPI:1881024107
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:OWNER AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCCURTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
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:
Practice Address - Street 1:2530 SE BURNSIDE RD
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-1245
Practice Address - Country:US
Practice Address - Phone:503-491-1723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1070450002Medicare NSC