Provider Demographics
NPI:1790955003
Name:DAVID HIGGINSON DC PC
Entity Type:Organization
Organization Name:DAVID HIGGINSON DC PC
Other - Org Name:HIGHLAND CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:HIGGINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-546-9987
Mailing Address - Street 1:3531 NE 15TH AVE STE E
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2377
Mailing Address - Country:US
Mailing Address - Phone:503-546-9987
Mailing Address - Fax:503-546-9988
Practice Address - Street 1:3531 NE 15TH AVE STE E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-2377
Practice Address - Country:US
Practice Address - Phone:503-546-9987
Practice Address - Fax:503-546-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3643261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center