NPI 1134102320

Steven Gary Tillett, DPM

Practitioner Foot Surgery Podiatrist Portland, OR

Practice location

Address: 6274 SW Capitol Hwy, Portland, OR 97239-2674
Phone: (503) 246-2212

Registered specialties

Foot Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0131X Licence DP00300 (OR)

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Registry record

NPI: 1134102320
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Nov 2005
Record last updated: 12 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.