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Contact Information

COREY J VANDE ZANDSCHULP, MD
4103 MERCANTILE DR
LAKE OSWEGO, OR97035
 Phone: 503-850-9940
 Fax: 503-850-6709
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Orthopaedic Trauma

207XX0801X 02 Physician/General Surgery
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for COREY J VANDE ZANDSCHULP · (Male)

NPI # 1477567402
Status Active
Credentials MD
Entity Individual
Enumeration date 07/27/2006
Last updated 11/21/2025 - About 7 months ago
Sole proprietor 1 Yes
Identifiers
  • OR License # MD24129
  • WA License # MD6143532
  • OR Medicaid 241316
Hospital affiliation(s)
  • LEGACY EMANUEL MEDICAL CENTER - (Acute Care)
    2801 N GANTENBEIN AVENUE
    PORTLAND, OR 97227
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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