Provider Demographics
NPI:1609923200
Name:CHECKAL, JOHN T (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:CHECKAL
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:PO BOX 422
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINS
Mailing Address - State:OR
Mailing Address - Zip Code:97133-0422
Mailing Address - Country:US
Mailing Address - Phone:503-640-1600
Mailing Address - Fax:503-640-1603
Practice Address - Street 1:341 NE LINCOLN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-3145
Practice Address - Country:US
Practice Address - Phone:503-640-1600
Practice Address - Fax:503-640-1603
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1171111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000QCBDMMedicare ID - Type Unspecified