Individual provider · Type 1 NPI
Daniel John Granville, DPM
Foot & Ankle Surgery Podiatrist · Clackamas, OR
NPI number
1174623714
Active
Practice location
10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Mailing address
2551 Beacon Hill Dr
West Linn, OR 97068-3689
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO00000601 (WA) |
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | DP00222 (OR) |
Foot & Ankle Surgery Podiatrist: Definition to come...
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About NPI 1174623714
Daniel John Granville, DPM's National Provider Identifier is 1174623714, issued on Sep 24, 2006. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Clackamas, OR. The record was last updated on Feb 4, 2022.