Provider Demographics
NPI:1518919851
Name:MARRONE, ANTHONY DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DAVID
Last Name:MARRONE
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 1:801 NE 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2408
Mailing Address - Country:US
Mailing Address - Phone:503-281-4997
Mailing Address - Fax:
Practice Address - Street 1:801 NE 28TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2408
Practice Address - Country:US
Practice Address - Phone:503-281-4997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3470111NR0400X
OR27 3470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation