Provider Demographics
NPI:1669459400
Name:ARNOT, MICHAEL JUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JUSTIN
Last Name:ARNOT
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 1:2172 SW PARK PL
Mailing Address - Street 2:UNIT A
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1125
Mailing Address - Country:US
Mailing Address - Phone:503-246-1881
Mailing Address - Fax:
Practice Address - Street 1:6339 SW CAPITOL HWY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-1937
Practice Address - Country:US
Practice Address - Phone:503-246-1881
Practice Address - Fax:503-246-1557
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3360111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR114446Medicare ID - Type Unspecified
ORU31747Medicare UPIN