Provider Demographics
NPI:1558424960
Name:DAVID RHEAUME, DC.PC
Entity Type:Organization
Organization Name:DAVID RHEAUME, DC.PC
Other - Org Name:CROSSWINDS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RHEAUME
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCO, CCSP
Authorized Official - Phone:503-657-9380
Mailing Address - Street 1:15328 SE 94TH AVE
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9601
Mailing Address - Country:US
Mailing Address - Phone:503-657-9380
Mailing Address - Fax:503-657-7417
Practice Address - Street 1:15328 SE 94TH AVE
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9601
Practice Address - Country:US
Practice Address - Phone:503-657-9380
Practice Address - Fax:503-657-7417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272503305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization