Provider Demographics
NPI:1205546629
Name:THERESA M. RUBADUE-DOI DC, LLC
Entity type:Organization
Organization Name:THERESA M. RUBADUE-DOI DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RUBADUE-DOI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-388-2429
Mailing Address - Street 1:628 NW YORK DR STE 104
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1572
Mailing Address - Country:US
Mailing Address - Phone:541-388-2429
Mailing Address - Fax:
Practice Address - Street 1:628 NW YORK DR STE 104
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-1572
Practice Address - Country:US
Practice Address - Phone:541-388-2429
Practice Address - Fax:541-388-2439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST CROSSING CHIROPRACTIC & HHEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1548664279OtherCHIROPRACTIC