Provider Demographics
NPI:1356054357
Name:POLASKI, MADDIE (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:MADDIE
Middle Name:
Last Name:POLASKI
Suffix:
Gender:F
Credentials:DC, CCSP
Other - Prefix:DR
Other - First Name:MADDIE
Other - Middle Name:
Other - Last Name:LINDSAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, CCSP
Mailing Address - Street 1:424 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-2026
Mailing Address - Country:US
Mailing Address - Phone:541-561-5111
Mailing Address - Fax:
Practice Address - Street 1:424 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-2026
Practice Address - Country:US
Practice Address - Phone:541-278-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor