Provider Demographics
NPI:1780048694
Name:GULLIKSON, CARESSA (DC)
Entity type:Individual
Prefix:DR
First Name:CARESSA
Middle Name:
Last Name:GULLIKSON
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 1:108 E HERSEY ST
Mailing Address - Street 2:STE 2A
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1363
Mailing Address - Country:US
Mailing Address - Phone:503-582-9200
Mailing Address - Fax:503-582-1487
Practice Address - Street 1:108 E HERSEY ST
Practice Address - Street 2:# 2A
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1363
Practice Address - Country:US
Practice Address - Phone:541-482-3492
Practice Address - Fax:541-482-4203
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor