Provider Demographics
NPI:1679638597
Name:WATSON, AMELIE HOOKER (DC)
Entity Type:Individual
Prefix:DR
First Name:AMELIE
Middle Name:HOOKER
Last Name:WATSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5515 NE 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-6805
Mailing Address - Country:US
Mailing Address - Phone:503-282-1118
Mailing Address - Fax:503-914-0417
Practice Address - Street 1:5515 NE 30TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-6805
Practice Address - Country:US
Practice Address - Phone:503-282-1118
Practice Address - Fax:503-914-0417
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor