Provider Demographics
NPI:1669127916
Name:FLORES, OMAR ALEJANDRO (DC)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:ALEJANDRO
Last Name:FLORES
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 1:4801 E 5TH ST APT C309
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-6007
Mailing Address - Country:US
Mailing Address - Phone:360-504-7349
Mailing Address - Fax:
Practice Address - Street 1:221A NE 104TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-4539
Practice Address - Country:US
Practice Address - Phone:360-464-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61246503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor