MEDICARE: DANIELLE ERIN MCCARY 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	5016	OR

General Provider Information

NPI Number	:	1730446345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE ERIN MCCARY DC

Provider Business Mailing Address
First Line	:	2705 E BURNSIDE ST STE 213
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1768
Country	:	US
Telephone Number	:	503-234-4288
Fax Number	:	503-234-8613

Provider Business Practice Location Address
First Line	:	2705 E BURNSIDE ST STE 213
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1768
Country	:	US
Telephone Number	:	503-234-4288
Fax Number	:	503-234-8613

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

Provider Enumeration Date	:	04/19/2012
Last Update Date	:	03/08/2016

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