Provider Demographics
NPI:1720647100
Name:ENDURANCE FOOT AND ANKLE, LLC
Entity Type:Organization
Organization Name:ENDURANCE FOOT AND ANKLE, LLC
Other - Org Name:ENDURANCE FOOT AND ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:KIRK
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:909-215-3370
Mailing Address - Street 1:175 1ST PL NW STE B
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2746
Mailing Address - Country:US
Mailing Address - Phone:425-780-7055
Mailing Address - Fax:425-968-1233
Practice Address - Street 1:175 1ST PL NW STE B
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2746
Practice Address - Country:US
Practice Address - Phone:425-780-7055
Practice Address - Fax:425-968-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric