Provider Demographics
NPI:1184877243
Name:CLUNES CORPORATION
Entity type:Organization
Organization Name:CLUNES CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLUNES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-656-0362
Mailing Address - Street 1:21810 WILLAMETTE DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3256
Mailing Address - Country:US
Mailing Address - Phone:503-656-0362
Mailing Address - Fax:503-656-0182
Practice Address - Street 1:21810 WILLAMETTE DR
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3256
Practice Address - Country:US
Practice Address - Phone:503-656-0362
Practice Address - Fax:503-656-0182
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLUNES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-02
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2314261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR104197Medicare PIN