Provider Demographics
NPI:1700949674
Name:HARDEN CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HARDEN CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-225-9033
Mailing Address - Street 1:4425 SW CORBETT AVE UPPR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4287
Mailing Address - Country:US
Mailing Address - Phone:503-225-9033
Mailing Address - Fax:503-225-9039
Practice Address - Street 1:4425 SW CORBETT AVE UPPR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4287
Practice Address - Country:US
Practice Address - Phone:503-225-9033
Practice Address - Fax:503-225-9039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID
=========OtherTAX ID