Provider Demographics
NPI:1942299557
Name:ULBRICH, GEORGE ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALAN
Last Name:ULBRICH
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 1:6422 SE MILWAUKIE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5518
Mailing Address - Country:US
Mailing Address - Phone:503-235-9238
Mailing Address - Fax:503-235-4226
Practice Address - Street 1:6422 SE MILWAUKIE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5518
Practice Address - Country:US
Practice Address - Phone:503-235-9238
Practice Address - Fax:503-235-4226
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272122111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR115871Medicare ID - Type Unspecified