Provider Demographics
NPI:1710028782
Name:SABOE, LAVERNE ALDEN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:LAVERNE
Middle Name:ALDEN
Last Name:SABOE
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 1:915 19TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-4228
Mailing Address - Country:US
Mailing Address - Phone:541-926-3162
Mailing Address - Fax:541-928-2742
Practice Address - Street 1:915 19TH AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-4228
Practice Address - Country:US
Practice Address - Phone:541-926-3162
Practice Address - Fax:541-928-2742
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1647111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic