Tillett, Steven Gary
Tillett, Steven Gary is an sole proprietor health care provider with primary practice located at 6274 Sw Capitol Hwy , Portland OR 97239-2674. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Tillett, Steven Gary can be contacted via phone (503) 246-2212.Contact Information
Primary practice address
6274 Sw Capitol Hwy
Portland OR 97239-2674
Phone: (503) 246-2212
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | DP00300 | Oregon |
Profile Details
| NPI number | 1134102320 |
|---|---|
| LBN Legal business name | Tillett, Steven Gary |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Feb 12th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134102320 | NPPES |
| Other | 831001001 | BC | |
| Other | 480031007 | BC | |
| Other | 227113 | BC | |
| MEDICAID | 227113 | BC |
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