Provider Demographics
NPI:1407910417
Name:SARNOSKI, ADAM WADE (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:WADE
Last Name:SARNOSKI
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:PO BOX 600
Mailing Address - Street 2:
Mailing Address - City:SUTHERLIN
Mailing Address - State:OR
Mailing Address - Zip Code:97479-0600
Mailing Address - Country:US
Mailing Address - Phone:541-459-2583
Mailing Address - Fax:541-459-9238
Practice Address - Street 1:219 N. UMPQUA ST.
Practice Address - Street 2:
Practice Address - City:SUTHERLIN
Practice Address - State:OR
Practice Address - Zip Code:97479
Practice Address - Country:US
Practice Address - Phone:541-459-2583
Practice Address - Fax:541-459-9238
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU99832Medicare UPIN
OR119161Medicare PIN