Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | DP00439 | OR |
N | 222Z00000X | Podiatrist | DP00439 | OR |
Y | 213ES0103X | Foot & Ankle Surgery | DP00439 | OR |
NPI | 1063630929 |
---|---|
Provider Name | Amanda K Westfall |
First Address | Bend, OR 97702-1697 |
Second Address | Bend, OR 97702-1697 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 28/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
026196 | (05) | OR |
820226002 | BCBSO (01) | OR |