Provider Demographics
NPI:1033629795
Name:MADDOX, CATHERINE (DC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MADDOX
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4531 SE BELMONT ST
Mailing Address - Street 2:STE 207
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-9998
Mailing Address - Country:US
Mailing Address - Phone:503-660-8874
Mailing Address - Fax:503-662-8654
Practice Address - Street 1:4531 SE BELMONT ST
Practice Address - Street 2:STE 207
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215
Practice Address - Country:US
Practice Address - Phone:503-660-8874
Practice Address - Fax:503-662-8654
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5854111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor