Provider Demographics
NPI:1255377792
Name:MAREECHI DUVVURI DC PC
Entity type:Organization
Organization Name:MAREECHI DUVVURI DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAREECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUVVURI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-803-4564
Mailing Address - Street 1:2953 SE TURNER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-7944
Mailing Address - Country:US
Mailing Address - Phone:503-803-4564
Mailing Address - Fax:503-648-6076
Practice Address - Street 1:2953 SE TURNER CREEK DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-7944
Practice Address - Country:US
Practice Address - Phone:503-803-4564
Practice Address - Fax:503-648-6076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty