Provider Demographics
NPI:1407518293
Name:CHARLAT, DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:CHARLAT
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 1:10729 SE 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-7601
Mailing Address - Country:US
Mailing Address - Phone:971-236-4348
Mailing Address - Fax:503-300-2308
Practice Address - Street 1:10729 SE 82ND AVE
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-7601
Practice Address - Country:US
Practice Address - Phone:971-236-4348
Practice Address - Fax:503-300-2308
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR6179OtherCHIROPRACTIC LICENSE NUMBER