Provider Demographics
NPI:1205989092
Name:LORD, CHRISTINE DUGGAN (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:DUGGAN
Last Name:LORD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 SW MARLOW AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5145
Mailing Address - Country:US
Mailing Address - Phone:503-892-3600
Mailing Address - Fax:503-892-3070
Practice Address - Street 1:1410 SW MARLOW AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5145
Practice Address - Country:US
Practice Address - Phone:503-892-3600
Practice Address - Fax:503-892-3070
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR802797001OtherBLUECROSS BLUESHEILD
OR802797001OtherBLUECROSS BLUESHEILD
R113080Medicare PIN