Provider Demographics
NPI:1841529955
Name:ISAKSEN, ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:ISAKSEN
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 1:1797 LANSING AVE NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-8732
Mailing Address - Country:US
Mailing Address - Phone:503-391-9112
Mailing Address - Fax:866-486-2406
Practice Address - Street 1:1797 LANSING AVE NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-8732
Practice Address - Country:US
Practice Address - Phone:503-391-9112
Practice Address - Fax:866-486-2406
Is Sole Proprietor?:No
Enumeration Date:2009-12-18
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor