Provider Demographics
NPI:1689892655
Name:DON WHITE RN DC PC
Entity Type:Organization
Organization Name:DON WHITE RN DC PC
Other - Org Name:CANYON ROAD CHIROPRACTIC & MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN, DC
Authorized Official - Phone:503-641-8000
Mailing Address - Street 1:12850 SW CANYON RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2166
Mailing Address - Country:US
Mailing Address - Phone:503-641-8000
Mailing Address - Fax:503-520-9159
Practice Address - Street 1:12850 SW CANYON RD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2166
Practice Address - Country:US
Practice Address - Phone:503-641-8000
Practice Address - Fax:503-520-9159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty