Provider Demographics
NPI:1639391659
Name:SCHAEFFER, DELBERT HAROLD (DC)
Entity type:Individual
Prefix:DR
First Name:DELBERT
Middle Name:HAROLD
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DEL
Other - Middle Name:
Other - Last Name:SCHAEFFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1090 24TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-7539
Mailing Address - Country:US
Mailing Address - Phone:541-928-5411
Mailing Address - Fax:541-928-5412
Practice Address - Street 1:1090 24TH AVE SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-7539
Practice Address - Country:US
Practice Address - Phone:541-928-5411
Practice Address - Fax:541-928-5412
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1212111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000QGBFGMedicare PIN