Provider Demographics
NPI:1427344563
Name:HEGEWALD, KENNETH WEBSTER (DPM)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:WEBSTER
Last Name:HEGEWALD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:17355 LOWER BOONES FERRY RD
Mailing Address - Street 2:STE 100A
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97035
Mailing Address - Country:US
Mailing Address - Phone:503-224-8399
Mailing Address - Fax:503-224-5661
Practice Address - Street 1:17355 LOWER BOONES FERRY RD
Practice Address - Street 2:STE 100A
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97035
Practice Address - Country:US
Practice Address - Phone:503-224-8399
Practice Address - Fax:503-224-5661
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPL60221075213ES0103X
AZ0808213ES0131X
ORDP177024213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery