Provider Demographics
NPI:1265609713
Name:NORTH PORTLAND CHIROPRACTIC CLINIC INC
Entity type:Organization
Organization Name:NORTH PORTLAND CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ORREN
Authorized Official - Last Name:HALKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-285-4137
Mailing Address - Street 1:3605 N LOMBARD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217
Mailing Address - Country:US
Mailing Address - Phone:503-285-4137
Mailing Address - Fax:503-285-8873
Practice Address - Street 1:3605 N LOMBARD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217
Practice Address - Country:US
Practice Address - Phone:503-285-4137
Practice Address - Fax:503-285-8873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty