Provider Demographics
NPI:1164642658
Name:ANDERSEN, HANS CHRISTIAN (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:HANS
Middle Name:CHRISTIAN
Last Name:ANDERSEN
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 SE MORRISON ST
Mailing Address - Street 2:SUITE 245
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-6307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:819 SE MORRISON ST
Practice Address - Street 2:SUITE 245
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-6307
Practice Address - Country:US
Practice Address - Phone:503-234-6631
Practice Address - Fax:503-234-9955
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3513111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology