Provider Demographics
NPI:1790959468
Name:WRIGHT, DANIEL S (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:WRIGHT
Suffix:
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 1:230 NE 2ND AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-3074
Mailing Address - Country:US
Mailing Address - Phone:503-640-2800
Mailing Address - Fax:503-846-9230
Practice Address - Street 1:230 NE 2ND AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-3074
Practice Address - Country:US
Practice Address - Phone:503-640-2800
Practice Address - Fax:503-846-9230
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 2889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U56367Medicare UPIN
0000QGHDKMedicare PIN