Provider Demographics
NPI:1891163515
Name:FUNK, ANDREW JOSEPH (DC, DACNB)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:FUNK
Suffix:
Gender:M
Credentials:DC, DACNB
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 STE 1
Mailing Address - Street 2:
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 STE 1
Practice Address - Street 2:
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:2015-09-11
Last Update Date:2022-11-02
Deactivation Date:2022-10-05
Deactivation Code:
Reactivation Date:2022-10-19
Provider Licenses
StateLicense IDTaxonomies
OR5658111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology