Provider Demographics
NPI:1578904249
Name:BERNINGHAUSEN, MEGHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:
Last Name:BERNINGHAUSEN
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 1:3120 SE 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-1820
Mailing Address - Country:US
Mailing Address - Phone:971-708-2121
Mailing Address - Fax:
Practice Address - Street 1:6245 E BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1312
Practice Address - Country:US
Practice Address - Phone:503-236-3806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor