Provider Demographics
NPI:1598993073
Name:LYBARGER, JAMES J (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:LYBARGER
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 1:8861 SW COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223
Mailing Address - Country:US
Mailing Address - Phone:503-603-0300
Mailing Address - Fax:503-603-0302
Practice Address - Street 1:8861 SW COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-603-0300
Practice Address - Fax:503-603-0302
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor