Provider Demographics
NPI:1891867891
Name:BEEBE, DANIEL D (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:D
Last Name:BEEBE
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 1:13500 SW 72ND AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8013
Mailing Address - Country:US
Mailing Address - Phone:503-620-1280
Mailing Address - Fax:503-620-6062
Practice Address - Street 1:13500 SW 72ND AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8013
Practice Address - Country:US
Practice Address - Phone:503-620-1280
Practice Address - Fax:503-620-6062
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 1652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000QGCLNMedicare PIN