Provider Demographics
NPI:1457325235
Name:BUTLER, DAVID CARLTON (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CARLTON
Last Name:BUTLER
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 SW 7TH ST
Mailing Address - Street 2:PO BOX 2294
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2709
Mailing Address - Country:US
Mailing Address - Phone:541-548-0125
Mailing Address - Fax:
Practice Address - Street 1:537 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2709
Practice Address - Country:US
Practice Address - Phone:541-548-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 2181111N00000X
WA2042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR120475Medicare ID - Type Unspecified