Provider Demographics
NPI:1780025304
Name:JEFFERS, ALICIA (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:JEFFERS
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 1:130 SW 2ND AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-4157
Mailing Address - Country:US
Mailing Address - Phone:503-263-3033
Mailing Address - Fax:503-263-3023
Practice Address - Street 1:12143A NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-2074
Practice Address - Country:US
Practice Address - Phone:503-505-3842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor