Provider Demographics
NPI:1780813709
Name:HUMBERSTON, AARON SHAWN (DC)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:SHAWN
Last Name:HUMBERSTON
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 1:2008 WILLAMETTE FALLS DR
Mailing Address - Street 2:SUITE 200 A
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4658
Mailing Address - Country:US
Mailing Address - Phone:503-607-0018
Mailing Address - Fax:503-723-5112
Practice Address - Street 1:2008 WILLAMETTE FALLS DR
Practice Address - Street 2:SUITE 200 A
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4658
Practice Address - Country:US
Practice Address - Phone:503-607-0018
Practice Address - Fax:503-723-5112
Is Sole Proprietor?:No
Enumeration Date:2009-07-12
Last Update Date:2009-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor