Provider Demographics
NPI:1740751601
Name:BRYMER, DELENA JAELAINE (DC)
Entity type:Individual
Prefix:MISS
First Name:DELENA
Middle Name:JAELAINE
Last Name:BRYMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 STILSON LN S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-9850
Mailing Address - Country:US
Mailing Address - Phone:503-559-7274
Mailing Address - Fax:
Practice Address - Street 1:7447 STILSON LN S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-9850
Practice Address - Country:US
Practice Address - Phone:503-559-7274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor