Provider Demographics
NPI:1427150028
Name:CHRISTOPHER S. SEUFERLING DPM PC
Entity type:Organization
Organization Name:CHRISTOPHER S. SEUFERLING DPM PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SEUFERLING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:503-775-5846
Mailing Address - Street 1:7940 SE DIVISION ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-1046
Mailing Address - Country:US
Mailing Address - Phone:503-775-5846
Mailing Address - Fax:503-775-8054
Practice Address - Street 1:7940 SE DIVISION ST
Practice Address - Street 2:SUITE E
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-1046
Practice Address - Country:US
Practice Address - Phone:503-775-5846
Practice Address - Fax:503-775-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-03
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP00362213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213458Medicaid
ORR136547Medicare PIN
OR213458Medicaid
ORV05636Medicare UPIN
ORR136546Medicare PIN