Healthcare Provider Details

I. General information

NPI: 1679482905
Provider Name (Legal Business Name): JOHN ALLEN OLIVEIRA III DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 NE 2ND ST
BEND OR
97701-4344
US

IV. Provider business mailing address

1334 NE 2ND ST
BEND OR
97701-4344
US

V. Phone/Fax

Practice location:
  • Phone: 541-797-6530
  • Fax: 541-318-0964
Mailing address:
  • Phone: 541-797-6530
  • Fax: 541-318-0964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6530
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: