Provider Demographics
NPI:1912042268
Name:ROBERTSON, BARBARA JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JEAN
Last Name:ROBERTSON
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 1:2335 DOUGLAS DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1711
Mailing Address - Country:US
Mailing Address - Phone:541-359-7531
Mailing Address - Fax:541-683-3102
Practice Address - Street 1:358 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2835
Practice Address - Country:US
Practice Address - Phone:541-359-7531
Practice Address - Fax:541-683-3102
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU06419Medicare UPIN