Provider Demographics
NPI:1306022553
Name:RICHARDSON, JOHN COLEMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:COLEMAN
Last Name:RICHARDSON
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 1:2251 SE TUALATIN VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-7975
Mailing Address - Country:US
Mailing Address - Phone:503-648-4357
Mailing Address - Fax:503-648-4358
Practice Address - Street 1:2251 SE TUALATIN VALLEY HWY
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-7975
Practice Address - Country:US
Practice Address - Phone:503-648-4357
Practice Address - Fax:503-648-4358
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30686111N00000X
OR3934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1306022553OtherNPI