Provider Demographics
NPI:1649262379
Name:LANNING, JASON GEORGE (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:GEORGE
Last Name:LANNING
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 1:2300 SW 2ND ST STE C
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-5486
Mailing Address - Country:US
Mailing Address - Phone:503-474-0664
Mailing Address - Fax:503-474-3856
Practice Address - Street 1:2300 SW 2ND ST STE C
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-5486
Practice Address - Country:US
Practice Address - Phone:503-474-0664
Practice Address - Fax:503-474-3856
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORV01295Medicare UPIN
ORR137287Medicare PIN