Provider Demographics
NPI:1215194592
Name:TURNER, DYLAN CLUNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:CLUNE
Last Name:TURNER
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 1:17800 SE MCKINLEY RD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-3217
Mailing Address - Country:US
Mailing Address - Phone:503-457-6194
Mailing Address - Fax:
Practice Address - Street 1:10555 SE 82ND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-2374
Practice Address - Country:US
Practice Address - Phone:503-457-6194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3830111N00000X
OROR-RPH133311835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist