Provider Demographics
NPI:1366451973
Name:FUEGY, DONALD W (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:W
Last Name:FUEGY
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 1:13750 SW FAIRVIEW CT
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-2820
Mailing Address - Country:US
Mailing Address - Phone:925-462-1100
Mailing Address - Fax:
Practice Address - Street 1:13750 SW FAIRVIEW CT
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-2820
Practice Address - Country:US
Practice Address - Phone:925-462-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA81-0650979Medicare UPIN