Provider Demographics
NPI:1407119605
Name:VANCE, JOSEPH ELIAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ELIAS
Last Name:VANCE
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 1:8047 SW 56TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3220
Mailing Address - Country:US
Mailing Address - Phone:404-661-8833
Mailing Address - Fax:
Practice Address - Street 1:4670 SW WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-0530
Practice Address - Country:US
Practice Address - Phone:503-646-8575
Practice Address - Fax:503-526-0783
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR4017111NN0400X
OR4017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology