Provider Demographics
NPI:1508924523
Name:FOSTER, JEFFREY L (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:FOSTER
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 1:825 MONROE ST STE 4
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-5176
Mailing Address - Country:US
Mailing Address - Phone:503-407-5265
Mailing Address - Fax:
Practice Address - Street 1:825 MONROE ST STE 4
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5176
Practice Address - Country:US
Practice Address - Phone:503-407-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3697OtherOREGON STATE BOARD LICENSE NUMBER