Provider Demographics
NPI:1023194792
Name:TUTTLE, JOHN SWC (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SWC
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4475 SW SCHOLLS FERRY RD
Mailing Address - Street 2:STE 210
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1955
Mailing Address - Country:US
Mailing Address - Phone:503-292-0781
Mailing Address - Fax:
Practice Address - Street 1:4475 SW SCHOLLS FERRY RD
Practice Address - Street 2:STE 210
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1955
Practice Address - Country:US
Practice Address - Phone:503-292-0781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 3304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor