Provider Demographics
NPI:1518317874
Name:HOLLINGSWORTH, TREVOR WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:WILLIAM
Last Name:HOLLINGSWORTH
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 1:11012 SW SPRINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-3318
Mailing Address - Country:US
Mailing Address - Phone:971-241-6181
Mailing Address - Fax:503-520-0514
Practice Address - Street 1:11507 SW SHILO LN STE E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5923
Practice Address - Country:US
Practice Address - Phone:503-643-2225
Practice Address - Fax:503-520-0514
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5736111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor