Provider Demographics
NPI:1770614521
Name:MACDONALD, GARRETH (DC)
Entity type:Individual
Prefix:DR
First Name:GARRETH
Middle Name:
Last Name:MACDONALD
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 1:90 E 27TH AVE
Mailing Address - Street 2:B
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3785
Mailing Address - Country:US
Mailing Address - Phone:541-343-4343
Mailing Address - Fax:541-485-2835
Practice Address - Street 1:90 E 27TH AVE
Practice Address - Street 2:B
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3785
Practice Address - Country:US
Practice Address - Phone:541-343-4343
Practice Address - Fax:541-485-2835
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor