Provider Demographics
NPI:1225086275
Name:SIMONS, DODI LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:DODI
Middle Name:LYNN
Last Name:SIMONS
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 1:233 E HISTORIC COLUMBIA RIVER HWY
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-2078
Mailing Address - Country:US
Mailing Address - Phone:503-491-9266
Mailing Address - Fax:503-491-0547
Practice Address - Street 1:233 E HISTORIC COLUMBIA RIVER HWY
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-2078
Practice Address - Country:US
Practice Address - Phone:503-491-9266
Practice Address - Fax:503-491-0547
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273088111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor