PEDORTHIC SERVICES, INC. (NPI# 1720351323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720351323 |
| Entity Type | Organization |
| Organization Name | PEDORTHIC SERVICES, INC. |
| Practice Address |
10240 Sw Nimbus Ave Suite L5 Portland OR 97223 |
| Practice Telephone | 5039926366 |
| Practice Fax Number | 5035248397 |
| Mailing Telephone | 5039926366 |
| Mailing Fax Number | 5035248397 |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2012-02-14 |
| Authorized Official Name | VINCENT WILLIAM CATANIA (OWNER) |
| Authorized Official Telephone | 5039926366 |
| Authorized Official Credential | C-PED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224L00000X | Pedorthist | NO LICENCSE REQU | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PEDORTHIC SERVICES, INC. | 10240 Sw Nimbus Ave, Ste L5, Portland, OR 97223 |
| Street Address |
10240 SW NIMBUS AVE SUITE L5 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558316851 | Pacific Footwear Company Inc | Durable Medical Equipment & Medical Supplies | 10240 Sw Nimbus Ave, Suite L1, Portland, OR 97223-4358 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 224L00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Pedorthist |
| An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. |
| Notes: Source: National Uniform Claim Committee [7/1/2010: new] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1639650054 | Pinnacle Orthotics, LLC | Pedorthist | 1310 Coburg Rd Ste 7, Eugene, OR 97401-5200 | 2018-08-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.