Pacific Footwear Company, Inc.
Customized Equipment
10240 Sw Nimbus Ave, Suite L1, Portland
Oregon, 97223
503-524-9656 503-524-8397
Pacific Footwear Company, Inc. is a Customized Equipment in Portland, Oregon. It is located at 10240 Sw Nimbus Ave, Suite L1, Portland and it's customer support contact number is 503-524-9656. The authorized person of Pacific Footwear Company, Inc. is Kevin W Clarke who is President of this DME and his contact number is 503-524-9656. Pacific Footwear Company, Inc. accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Pacific Footwear Company, Inc. is a medical supplier who supplies medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
DME Supplier Details:
Pacific Footwear Company, Inc. type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Pacific Footwear Company, Inc. |
| Type: | Customized Equipment |
| Location: | 10240 Sw Nimbus Ave, Suite L1, Portland,
Oregon, 97223 |
| Phone: | 503-524-9656 |
| Fax: | 503-524-8397 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Kevin W Clarke |
| Position: | President |
| Contact Number: | 503-524-9656 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1558316851 |
| NPI Enumeration Date: | 24 May, 2006 |
| NPI Last Update On: | 22 Apr, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Pacific Footwear Company, Inc. are as mentioned below.
| Specialization | License Number | State | Status | |
| Customized Equipment | | | Primary | |
| Prosthetic/orthotic Supplier | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 297988 | Medicaid | Oregon | |
| 9054784 | Medicaid | Washington | |
| 806954600 | Medicaid | Idaho | |
Medicare Enrollment:
Pacific Footwear Company, Inc. is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 5294936407 | O20100930060696 | Pacific Footwear Company Inc | DME SUPPLIER - MEDICAL SUPPLY COMPANY WITH PEDORTHIC PERSONNEL |
Products Available:
Pacific Footwear Company, Inc. has following products available for sale under medicare.
| Products: |
|---|
| • Diabetic Shoes & Inserts: Custom Fabricated | • Diabetic Shoes & Inserts: Prefabricated |
| • Orthoses: Custom Fabricated | • Orthoses: Off-the-shelf |
| • Orthoses: Prefabricated | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 10240 Sw Nimbus Ave, Suite L1
Portland, Oregon |
| Zip: | 97223 |
| Phone Number: | 503-524-9656 |
| Fax Number: | 503-524-8397 |
Patients can reach Pacific Footwear Company, Inc. at
10240 Sw Nimbus Ave, Suite L1, Portland, Oregon or can
call on customer care at 503-524-9656.
Comments/ Reviews:
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 July, 2026.