Provider Demographics
NPI:1417180423
Name:NEALON, KARIN (DC)
Entity Type:Individual
Prefix:DR
First Name:KARIN
Middle Name:
Last Name:NEALON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KARIN
Other - Middle Name:NEALON
Other - Last Name:RODRIGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3939 NE HANCOCK ST
Mailing Address - Street 2:SUITE 213
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-5321
Mailing Address - Country:US
Mailing Address - Phone:503-953-0139
Mailing Address - Fax:503-336-1041
Practice Address - Street 1:3939 NE HANCOCK ST
Practice Address - Street 2:SUITE 213
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-5321
Practice Address - Country:US
Practice Address - Phone:503-953-0139
Practice Address - Fax:503-336-1041
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR28186111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor