Provider Demographics
NPI:1396150652
Name:GOFF, JANA BALAS (DPM)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:BALAS
Last Name:GOFF
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 NE 44TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-1443
Mailing Address - Country:US
Mailing Address - Phone:503-284-2000
Mailing Address - Fax:503-284-2002
Practice Address - Street 1:1827 NE 44TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1443
Practice Address - Country:US
Practice Address - Phone:503-284-2000
Practice Address - Fax:503-284-2002
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP201896213E00000X
NH0368213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery