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Contact Information

EASTSIDE ORTHOPEDICS & SPORTS MEDICINE, LLC
6542 SE LAKE RD STE 201
MILWAUKIE, OR97222-2245
 Phone: 503-659-1769
 Fax: 503-659-7522
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for EASTSIDE ORTHOPEDICS SPORTS MEDICINE LLC · (Female)

NPI Number 1225567928
Status Active
Credentials
Entity Individual
Enumeration date 06/06/2017
Last updated 02/11/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • OR License # MD183085
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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