Provider Demographics
NPI:1811904972
Name:ORAHOOD, BRIAN GUY (DPM)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:GUY
Last Name:ORAHOOD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17200 NW CORRIDOR CT STE 108
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-3295
Mailing Address - Country:US
Mailing Address - Phone:503-292-9252
Mailing Address - Fax:503-992-6780
Practice Address - Street 1:17200 NW CORRIDOR CT STE 108
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-3295
Practice Address - Country:US
Practice Address - Phone:503-292-9252
Practice Address - Fax:503-992-6780
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP00614213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1811904972OtherRAILROAD MEDICARE
OR080747Medicaid
OR1811904972OtherRAILROAD MEDICARE