Provider Demographics
NPI:1073656658
Name:SIGRID K HODGES DC PC
Entity Type:Organization
Organization Name:SIGRID K HODGES DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIGRID
Authorized Official - Middle Name:K
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-844-7890
Mailing Address - Street 1:329 SE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4001
Mailing Address - Country:US
Mailing Address - Phone:503-844-7890
Mailing Address - Fax:503-547-8792
Practice Address - Street 1:329 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4001
Practice Address - Country:US
Practice Address - Phone:503-844-7890
Practice Address - Fax:503-547-8792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR71-3364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR181954Medicaid
ORU49807Medicare UPIN
OR181954Medicaid