Provider Demographics
NPI:1619038437
Name:INKROTE, LORI L (DC)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:L
Last Name:INKROTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:POSTLEWAIT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1364
Mailing Address - Street 2:
Mailing Address - City:MOLALLA
Mailing Address - State:OR
Mailing Address - Zip Code:97038-0215
Mailing Address - Country:US
Mailing Address - Phone:503-829-5674
Mailing Address - Fax:
Practice Address - Street 1:28301 S HIGHWAY 213
Practice Address - Street 2:
Practice Address - City:MOLALLA
Practice Address - State:OR
Practice Address - Zip Code:97038-9443
Practice Address - Country:US
Practice Address - Phone:503-829-5674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1876111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR130726Medicare PIN