Provider Demographics
NPI:1134386766
Name:ADAMS, PERRY JAMES (DC)
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:JAMES
Last Name:ADAMS
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 1:164 NE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-3131
Mailing Address - Country:US
Mailing Address - Phone:541-635-0202
Mailing Address - Fax:541-563-2771
Practice Address - Street 1:385 E ALSEA HWY
Practice Address - Street 2:
Practice Address - City:WALDPORT
Practice Address - State:OR
Practice Address - Zip Code:97394
Practice Address - Country:US
Practice Address - Phone:541-563-5581
Practice Address - Fax:541-563-2771
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR159059Medicare PIN