Provider Demographics
NPI:1477680338
Name:WARNER, MERRYLEE G (DC)
Entity Type:Individual
Prefix:DR
First Name:MERRYLEE
Middle Name:G
Last Name:WARNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 SE OAK ST STE J
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4245
Mailing Address - Country:US
Mailing Address - Phone:503-640-7246
Mailing Address - Fax:503-640-7248
Practice Address - Street 1:730 SE OAK ST STE J
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4245
Practice Address - Country:US
Practice Address - Phone:503-640-7246
Practice Address - Fax:503-640-7248
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor