Provider Demographics
NPI:1821334004
Name:ELMORE, NESBITT DURR (ND, DC LAC)
Entity Type:Individual
Prefix:DR
First Name:NESBITT
Middle Name:DURR
Last Name:ELMORE
Suffix:
Gender:M
Credentials:ND, DC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14653 S GRAVES RD
Mailing Address - Street 2:
Mailing Address - City:MULINO
Mailing Address - State:OR
Mailing Address - Zip Code:97042-9793
Mailing Address - Country:US
Mailing Address - Phone:503-829-3060
Mailing Address - Fax:
Practice Address - Street 1:14653 S GRAVES RD
Practice Address - Street 2:
Practice Address - City:MULINO
Practice Address - State:OR
Practice Address - Zip Code:97042-9793
Practice Address - Country:US
Practice Address - Phone:503-829-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1801111N00000X
OR0607175F00000X
ORAC00894171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist