MEDICARE: DR. SETH A GOLDSTEIN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3315	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063489508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SETH A GOLDSTEIN DC

Provider Business Mailing Address
First Line	:	PO BOX 1465
Second Line	:
City	:	CANNON BEACH
State	:	OR
Zip	:	97110-1465
Country	:	US
Telephone Number	:	503-436-0335
Fax Number	:	503-436-0604

Provider Business Practice Location Address
First Line	:	231 N HEMLOCK ST
Second Line	:	SUITE 106
City	:	CANNON BEACH
State	:	OR
Zip	:	97110-1465
Country	:	US
Telephone Number	:	503-436-0335
Fax Number	:	503-436-0604

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	08/02/2012

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Directions to “ DR. SETH A GOLDSTEIN DC” Practice Location

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