Provider Demographics
NPI:1780853283
Name:GARD, ZANE R JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ZANE
Middle Name:R
Last Name:GARD
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 1:15220 NW GREENBRIER PARKWAY, SUITE 260
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006
Mailing Address - Country:US
Mailing Address - Phone:503-439-9494
Mailing Address - Fax:503-645-4404
Practice Address - Street 1:15220 NW GREENBRIER PARKWAY, SUITE 260
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006
Practice Address - Country:US
Practice Address - Phone:503-439-9494
Practice Address - Fax:503-645-4404
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR109177Medicare PIN