Provider Demographics
NPI:1356348650
Name:KHALSA, HARI DASS SINGH (DC)
Entity type:Individual
Prefix:DR
First Name:HARI DASS
Middle Name:SINGH
Last Name:KHALSA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5013 SE HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-3255
Mailing Address - Country:US
Mailing Address - Phone:503-238-1032
Mailing Address - Fax:503-233-1916
Practice Address - Street 1:5013 SE HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-3255
Practice Address - Country:US
Practice Address - Phone:503-238-1032
Practice Address - Fax:503-233-1916
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3530716OtherCIGNA
OR000000005009OtherHEALTH FUTURE / NCSD
ORJ2037OtherPACIFIC SOURCE
OR0004568715OtherAETNA
OR026824000OtherREGENCE BCBS OF OR
OR370078OtherAMERICAN SPECIALTY HEALTH
OR370078OtherAMERICAN SPECIALTY HEALTH