Provider Demographics
NPI:1285080556
Name:WESTOVER, SEAN (DPM)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:WESTOVER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1227 NE 7TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1430
Mailing Address - Country:US
Mailing Address - Phone:541-471-3668
Mailing Address - Fax:541-471-4814
Practice Address - Street 1:3474 LIBERTY RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4607
Practice Address - Country:US
Practice Address - Phone:035-888-1885
Practice Address - Fax:035-880-8845
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORDP194537213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery