Doctor Name: | EJIRO C ISIORHO |
NPI Number: | 1255650750 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | |
Business Practice Address: | 11515 Sw Durham Road E1 Tigard, OR - 97224 |
Business Phone Number: | 5036240364 |
Business Fax Number: | 5036843306 |
Mailing Address: | 11515 Sw Durham Road, E1 TIGARD |
State: | OR |
Postal Code: | 97224 |
Phone Number: | 5036240364 |
Fax Number: | 5036843306 |
NPI Enumeration Date: | 05/24/2010 |
NPI Last Update Date: | 06/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |