Healthcare Provider Details

I. General information

NPI: 1477705242
Provider Name (Legal Business Name): WALKER ROAD CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15220 NW GREENBRIER PARKWAY, SUITE 260
BEAVERTON OR
97006
US

IV. Provider business mailing address

15220 NW GREENBRIER PARKWAY, SUITE 260
BEAVERTON OR
97006
US

V. Phone/Fax

Practice location:
  • Phone: 503-439-9494
  • Fax: 503-645-4404
Mailing address:
  • Phone: 503-439-9494
  • Fax: 503-645-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ZANE RONALD GARD JR.
Title or Position: OWNER/PRESIDENT
Credential: D.C.
Phone: 503-439-9494