Provider Demographics
NPI:1609970656
Name:CLUEN, GEORGE JOHN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JOHN
Last Name:CLUEN
Suffix:JR
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 1:3220 N WILLIAMS AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1551
Mailing Address - Country:US
Mailing Address - Phone:503-282-4878
Mailing Address - Fax:503-282-4888
Practice Address - Street 1:3220 N WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1551
Practice Address - Country:US
Practice Address - Phone:503-282-4878
Practice Address - Fax:503-282-4888
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR71 3676111N00000X, 111N00000X
NJ38MC00532800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U77216Medicare UPIN
CADC0286450Medicaid
CADC0286450Medicare ID - Type Unspecified