Provider Demographics
NPI:1891189122
Name:MACLEAN, CHRISTINE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:MACLEAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 NE IRVING AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4738
Mailing Address - Country:US
Mailing Address - Phone:541-388-0496
Mailing Address - Fax:
Practice Address - Street 1:711 NE IRVING AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4738
Practice Address - Country:US
Practice Address - Phone:541-388-0496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor