Provider Demographics
NPI:1851560395
Name:MCCALL, MICHAEL CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHARLES
Last Name:MCCALL
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 1:15455 NW GREENBRIER PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8133
Mailing Address - Country:US
Mailing Address - Phone:503-200-5778
Mailing Address - Fax:503-200-5781
Practice Address - Street 1:15455 NW GREENBRIER PKWY STE 150
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-8133
Practice Address - Country:US
Practice Address - Phone:503-200-5778
Practice Address - Fax:503-200-5781
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-3236111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR109178Medicare PIN