Provider Demographics
NPI:1336303189
Name:SPELLMEYER, AMY LYNN (DC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:SPELLMEYER
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 1:14145 SW NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-2641
Mailing Address - Country:US
Mailing Address - Phone:503-310-3228
Mailing Address - Fax:
Practice Address - Street 1:5215 NE ELAM YOUNG PKWY
Practice Address - Street 2:STE. A
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6498
Practice Address - Country:US
Practice Address - Phone:503-693-9101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3824111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor