Provider Demographics
NPI:1134294739
Name:DUTTON, MICHAEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:DUTTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3295 TRIANGLE DR SE STE 115
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4566
Mailing Address - Country:US
Mailing Address - Phone:971-332-5609
Mailing Address - Fax:971-332-5732
Practice Address - Street 1:3295 TRIANGLE DR SE STE 115
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4566
Practice Address - Country:US
Practice Address - Phone:971-332-5609
Practice Address - Fax:971-332-5732
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor